Document Detail


Diastolic electromechanical coupling: association of the ECG T-peak to T-end interval with echocardiographic markers of diastolic dysfunction.
MedLine Citation:
PMID:  22467673     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Electromechanical coupling, a well-described phenomenon in systolic dysfunction, has not been well studied in diastole. We hypothesized that the ECG T-peak to T-end (TpTe) interval, representing transmural dispersion of repolarization, is associated with echocardiographic markers of diastolic dysfunction (DD).
METHODS AND RESULTS: We performed a prospective, cross-sectional study of the association between TpTe and markers of DD in 84 consecutive, unselected patients referred for exercise echocardiography. We systematically measured TpTe on the resting ECG, and we performed comprehensive assessment of DD at rest and at peak stress. ECGs and echocardiograms were analyzed independently, blinded to each other and to all clinical data. By univariable analysis, increased TpTe was associated with older age, increased E/e' ratio, and DD (P<0.05 for all associations after correcting for multiple comparisons). Increased TpTe was inversely associated with reduced tissue Doppler e' velocity, a marker of DD (R=-0.66, P<0.0001). This association persisted after adjusting for age, QTc, exercise-induced wall motion abnormalities, and left ventricular mass index (β=-0.41 [95% confidence interval, -0.70 to -0.12] cm/s per 10-ms increase in TpTe; P=0.006). Baseline TpTe was also independently associated with resting DD (adjusted odds ratio, 3.9 [95% confidence interval, 1.4-10.7]; P=0.009) and peak exercise E/e' ratio (P<0.0001).
CONCLUSIONS: Increased TpTe is associated with both resting and exercise-induced DD. Electromechanical coupling may represent a pathophysiologic link between electrical transmural dispersion of repolarization and abnormal myocardial relaxation, and may be a novel therapeutic target.
Authors:
Andrew Sauer; Jane E Wilcox; Adin-Cristian Andrei; Rod Passman; Jeffrey J Goldberger; Sanjiv J Shah
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-03-30
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  5     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-20     Completed Date:  2012-09-04     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  537-43     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA.
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MeSH Terms
Descriptor/Qualifier:
Cross-Sectional Studies
Diastole
Echocardiography, Doppler*
Electrocardiography*
Exercise Test
Female
Follow-Up Studies
Humans
Illinois / epidemiology
Incidence
Male
Middle Aged
Myocardial Contraction*
Prospective Studies
Ventricular Dysfunction, Left / diagnosis,  epidemiology,  physiopathology*
Grant Support
ID/Acronym/Agency:
R01 HL107557/HL/NHLBI NIH HHS; R01 HL107577/HL/NHLBI NIH HHS
Comments/Corrections

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