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T-Wave Amplitude Variability and the Risk of Death in Chagas Disease.
MedLine Citation:
PMID:  21235679     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
T-Wave Amplitude Variability in Chagas Disease. Introduction: Measurement of beat-to-beat T-wave amplitude variability (TWV) has been described as a promising new technique for the stratification of arrhythmic risk in postmyocardial infarction and dilated cardiomyopathy patients. Chagas disease (ChD) can lead to a potentially lethal cardiopathy that can present with ventricular arrhythmias, heart blocks, heart failure, and sudden death. The aim of the study was to evaluate the prognostic value of TWV in ChD patients in addition to traditional prognostic predictors. Methods and Results: The study enrolled 113 ambulatory ChD patients (62 men; age: 42 ± 9 years) in sinus rhythm and without other systemic diseases, evaluated by a standard clinical protocol. We computed TWV in 10-minute ECG recordings obtained in controlled resting conditions. TWV was defined as the median values among 8 consecutive 50-ms T-wave segments and dichotomized as either ≤ or > 30 μV(2) . The association of TWV and death was evaluated by Cox proportional-hazards analysis, considering other established predictors. During mean follow-up time of 106 ± 28 months, 14 patients died. A value of median TWV > 30 μV(2) predicts increased risk of death in a multivariate analysis (HR = 5.76, 95% CI 1.31-25.23, P = 0.014), in addition to depressed left ventricular function, presence of nonsustained ventricular tachycardia and QRS duration >133 ms. Conclusion: Repolarization variability, evaluated by TWV, is independently related to the risk of death in ChD. This noninvasive methodology could facilitate the identification of patients who may benefit from more aggressive therapeutic strategies. (J Cardiovasc Electrophysiol, Vol. pp. 1-7).
Authors:
Antonio Luiz Pinho Ribeiro; Manoel Otávio DA Costa Rocha; Paolo Terranova; Marco Cesarano; Maria DO Carmo Pereira Nunes; Federico Lombardi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-14
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  -     ISSN:  1540-8167     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Wiley Periodicals, Inc.
Affiliation:
Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais; Belo Horizonte, Brazil Cardiologia, Ospedale San Paolo, Dipartimento di Medicina, Chirurgia e Odontoiatria, University of Milan, Italy.
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