Document Detail


Association of Holter-based measures including T-wave alternans with risk of sudden cardiac death in the community-dwelling elderly: the Cardiovascular Health Study.
MedLine Citation:
PMID:  20096853     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Sudden cardiac death (SCD) can be the first manifestation of cardiovascular disease. Development of screening methods for higher/lower risk is critical.
METHODS: The Cardiovascular Health Study is a population-based study of risk factors for coronary heart disease and stroke those 65 years or older. Forty-nine (of 1649) with usable Holters and in normal sinus rhythm had SCD during follow-up and were matched with 2 controls, alive at the time of death of the case and not experiencing SCD on follow-up. Univariate and multivariate conditional logistic regression determined the association of Holter-based information and SCD.
RESULTS: In univariate models, the upper half of ventricular premature contraction (VPC) counts, abnormal heart rate turbulence, decreased normalized low-frequency power, increased T-wave alternans (TWA), and decreased the short-term fractal scaling exponent (DFA(1)) were associated with SCD, but time domain heart rate variability was not. In multivariate models, the upper half of VPC counts (odds ratio [OR], 6.6) and having TWA of 37 muV or greater on channel 2 (OR, 4.8) were independently associated with SCD. Also, the upper half of VPC counts (OR, 6.9) and having a DFA(1) of less than 1.05 (OR, 5.0) were independently associated with SCD. When additive effects were explored, having both higher VPCs and higher TWA was associated with an OR of 8.2 for SCD compared with 2.6 for having either. Also, having both higher VPCs and lower DFA(1) was associated with an OR of 9.6 for SCD compared with 3.1 for having either.
CONCLUSIONS: Results support a potential role for 24-hour Holter recordings to identify older adults at increased or lower risk of SCD.
Authors:
Phyllis K Stein; Devang Sanghavi; Nona Sotoodehnia; David S Siscovick; John Gottdiener
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-01-25
Journal Detail:
Title:  Journal of electrocardiology     Volume:  43     ISSN:  1532-8430     ISO Abbreviation:  J Electrocardiol     Publication Date:    2010 May-Jun
Date Detail:
Created Date:  2010-04-19     Completed Date:  2010-07-30     Revised Date:  2014-09-18    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  251-9     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Comorbidity
Coronary Artery Disease / diagnosis*,  mortality*
Death, Sudden, Cardiac / epidemiology*
Electrocardiography, Ambulatory / statistics & numerical data*
Female
Humans
Male
Prevalence
Prognosis
Reproducibility of Results
Risk Assessment / methods
Risk Factors
Sensitivity and Specificity
Survival Analysis
Survival Rate
United States / epidemiology
Ventricular Premature Complexes / diagnosis*,  mortality*
Grant Support
ID/Acronym/Agency:
N01 HC-15103/HC/NHLBI NIH HHS; N01 HC-55222/HC/NHLBI NIH HHS; N01 HC-75150/HC/NHLBI NIH HHS; N01-HC-35129/HC/NHLBI NIH HHS; N01-HC-45133/HC/NHLBI NIH HHS; N01-HC-85079/HC/NHLBI NIH HHS; N01-HC-85086/HC/NHLBI NIH HHS; R01 HL062181/HL/NHLBI NIH HHS; R01 HL062181-06/HL/NHLBI NIH HHS; R01 HL62181/HL/NHLBI NIH HHS; U01 HL080295/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
J Electrocardiol. 2010 Sep-Oct;43(5):463   [PMID:  20381062 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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