Document Detail


Usefulness of microvolt T-wave alternans for prediction of ventricular tachyarrhythmic events in patients with dilated cardiomyopathy: results from a prospective observational study.
MedLine Citation:
PMID:  12821251     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study was designed to evaluate the ability of microvolt-level T-wave alternans (MTWA) to identify prospectively patients with idiopathic dilated cardiomyopathy (DCM) at risk of ventricular tachyarrhythmic events and to compare its predictive accuracy with that of conventional risk stratifiers. BACKGROUND: Patients with DCM are at increased risk of sudden death from ventricular tachyarrhythmias. At present, there are no established methods of assessing this risk. METHODS: A total of 137 patients with DCM underwent risk stratification through assessment of MTWA, left ventricular ejection fraction, baroreflex sensitivity (BRS), heart rate variability, presence of nonsustained ventricular tachycardia (VT), signal-averaged electrocardiogram, and presence of intraventricular conduction defect. The study end point was either sudden death, resuscitated ventricular fibrillation, or documented hemodynamically unstable VT. RESULTS: During an average follow-up of 14 +/- 6 months, MTWA and BRS were significant univariate predictors of ventricular tachyarrhythmic events (p < 0.035 and p < 0.015, respectively). Multivariate Cox regression analysis revealed that only MTWA was a significant predictor. CONCLUSIONS: Microvolt-level T-wave alternans is a powerful independent predictor of ventricular tachyarrhythmic events in patients with DCM.
Authors:
Stefan H Hohnloser; Thomas Klingenheben; Daniel Bloomfield; Omar Dabbous; Richard J Cohen
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  41     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-24     Completed Date:  2003-07-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2220-4     Citation Subset:  AIM; IM; S    
Affiliation:
Department of Medicine, J. W. Goethe University, Frankfurt, Germany. hohnloser@em.uni-frankfurt.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiomyopathy, Dilated / complications*,  physiopathology*
Cohort Studies
Electrocardiography / methods*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Predictive Value of Tests
Prognosis
Prospective Studies
Reproducibility of Results
Risk Assessment / methods
Tachycardia, Ventricular / etiology*,  physiopathology*
Investigator
Investigator/Affiliation:
R J Cohen / MIT, Cambridge
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2003 Jun 18;41(12):2225-7   [PMID:  12821252 ]

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


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