Predictive significance for sudden death of microvolt-level T wave alternans in New York Heart Association class II congestive heart failure patients: a prospective study
Sudden cardiac death (SDC) is responsible for approximately 60-70% of deaths in New York Heart Association (NYHA) class II congestive heart failure (CHF) patients. Recently, microvolt-level T wave alternans has been proposed as a new noninvasive tool to identify CHF patients at risk for SCD and vent...
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Veröffentlicht in: | International journal of cardiology 2005-10, Vol.105 (1), p.53-57 |
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container_title | International journal of cardiology |
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creator | Baravelli, Massimo Salerno-Uriarte, Diego Guzzetti, Daniela Rossi, Maria Cristina Zoli, Laura Forzani, Teresio Salerno-Uriarte, Jorge A |
description | Sudden cardiac death (SDC) is responsible for approximately 60-70% of deaths in New York Heart Association (NYHA) class II congestive heart failure (CHF) patients. Recently, microvolt-level T wave alternans has been proposed as a new noninvasive tool to identify CHF patients at risk for SCD and ventricular tachycardia/fibrillation (VT/VF).
To determine the prognostic value of MTWA in NYHA class II patients.
Among 181 consecutive CHF patients with ischemic and nonischemic cardiomyopathy, 73 patients in NYHA class II with left ventricular ejection fraction |
doi_str_mv | 10.1016/j.ijcard.2004.12.026 |
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To determine the prognostic value of MTWA in NYHA class II patients.
Among 181 consecutive CHF patients with ischemic and nonischemic cardiomyopathy, 73 patients in NYHA class II with left ventricular ejection fraction <45% were selected and prospectively investigated. MTWA was determined during bicycle exercise testing. The study end point was defined as SCD, documented sustained VT/VF and appropriate implantable cardioverter defibrillator (ICD) shock.
MTWA was positive in 30 (41%) patients, negative in 26(36%) patients and indeterminate in 17 (23%) patients. During an average follow-up of 17.1+/-7.4 months, seven patients had an arrhythmic event in the MTWA positive group, whereas one and no events occurred in the indeterminate and negative group, respectively. From Kaplan-Meier univariate analysis and multivariate Cox analysis, MTWA was a significant arrhythmic risk stratifier (p=0.01 and p=0.03, respectively). Sensitivity, specificity, negative and positive predictive values of MTWA were 100%, 53%, 100% and 24%, respectively.
Our data suggest that MTWA is a promising predictor of arrhythmic events in NYHA class II CHF patients.</description><identifier>ISSN: 0167-5273</identifier><identifier>DOI: 10.1016/j.ijcard.2004.12.026</identifier><identifier>PMID: 16207545</identifier><language>eng</language><publisher>Netherlands</publisher><subject>Aged ; Arrhythmias, Cardiac - etiology ; Arrhythmias, Cardiac - physiopathology ; Cardiomyopathies - classification ; Cardiomyopathies - complications ; Cardiomyopathies - therapy ; Death, Sudden, Cardiac - etiology ; Defibrillators, Implantable ; Electrocardiography ; Exercise Test ; Female ; Follow-Up Studies ; Heart Failure - classification ; Heart Failure - complications ; Heart Failure - therapy ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Ischemia - complications ; Myocardial Ischemia - physiopathology ; Myocardial Ischemia - therapy ; Prognosis ; Prospective Studies ; Risk Factors ; Stroke Volume - physiology ; Treatment Outcome</subject><ispartof>International journal of cardiology, 2005-10, Vol.105 (1), p.53-57</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16207545$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baravelli, Massimo</creatorcontrib><creatorcontrib>Salerno-Uriarte, Diego</creatorcontrib><creatorcontrib>Guzzetti, Daniela</creatorcontrib><creatorcontrib>Rossi, Maria Cristina</creatorcontrib><creatorcontrib>Zoli, Laura</creatorcontrib><creatorcontrib>Forzani, Teresio</creatorcontrib><creatorcontrib>Salerno-Uriarte, Jorge A</creatorcontrib><title>Predictive significance for sudden death of microvolt-level T wave alternans in New York Heart Association class II congestive heart failure patients: a prospective study</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>Sudden cardiac death (SDC) is responsible for approximately 60-70% of deaths in New York Heart Association (NYHA) class II congestive heart failure (CHF) patients. Recently, microvolt-level T wave alternans has been proposed as a new noninvasive tool to identify CHF patients at risk for SCD and ventricular tachycardia/fibrillation (VT/VF).
To determine the prognostic value of MTWA in NYHA class II patients.
Among 181 consecutive CHF patients with ischemic and nonischemic cardiomyopathy, 73 patients in NYHA class II with left ventricular ejection fraction <45% were selected and prospectively investigated. MTWA was determined during bicycle exercise testing. The study end point was defined as SCD, documented sustained VT/VF and appropriate implantable cardioverter defibrillator (ICD) shock.
MTWA was positive in 30 (41%) patients, negative in 26(36%) patients and indeterminate in 17 (23%) patients. During an average follow-up of 17.1+/-7.4 months, seven patients had an arrhythmic event in the MTWA positive group, whereas one and no events occurred in the indeterminate and negative group, respectively. From Kaplan-Meier univariate analysis and multivariate Cox analysis, MTWA was a significant arrhythmic risk stratifier (p=0.01 and p=0.03, respectively). Sensitivity, specificity, negative and positive predictive values of MTWA were 100%, 53%, 100% and 24%, respectively.
Our data suggest that MTWA is a promising predictor of arrhythmic events in NYHA class II CHF patients.</description><subject>Aged</subject><subject>Arrhythmias, Cardiac - etiology</subject><subject>Arrhythmias, Cardiac - physiopathology</subject><subject>Cardiomyopathies - classification</subject><subject>Cardiomyopathies - complications</subject><subject>Cardiomyopathies - therapy</subject><subject>Death, Sudden, Cardiac - etiology</subject><subject>Defibrillators, Implantable</subject><subject>Electrocardiography</subject><subject>Exercise Test</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Failure - classification</subject><subject>Heart Failure - complications</subject><subject>Heart Failure - therapy</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Myocardial Ischemia - complications</subject><subject>Myocardial Ischemia - physiopathology</subject><subject>Myocardial Ischemia - therapy</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Stroke Volume - physiology</subject><subject>Treatment Outcome</subject><issn>0167-5273</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kEFv1DAQhX0A0VL4BwjNiVuC48ROwq2qgK5U0R7aQ0-rwR63Xrx2sJ2t-pf4lVhlOc3hfTPz3mPsQ8fbjnfq8651O43JtILzoe1Ey4V6xU6rNDZSjP0Je5vzjldxnqc37KRTgo9ykKfsz00i43RxB4LsHoKzTmPQBDYmyKsxFMAQlkeIFvZOp3iIvjSeDuThFp6w7qEvlAKGDC7AD3qC-5h-wSVhKnCec9QOi4sBtMecYbMBHcMD5Zefjy-URefXRLBUkELJXwBhSTEvdHRWVvP8jr226DO9P84zdvft6-3FZXN1_X1zcX7VLILPpZGcTx3NaKcaF_k0mqGXlvcopap9SKTZ2MFybqwSM2o189qQFFyhHjve92fs07-71cHvtfrc7l3W5D0GimveqkmpoZOigh-P4PpzT2a7JLfH9Lz9327_F6syfvo</recordid><startdate>20051020</startdate><enddate>20051020</enddate><creator>Baravelli, Massimo</creator><creator>Salerno-Uriarte, Diego</creator><creator>Guzzetti, Daniela</creator><creator>Rossi, Maria Cristina</creator><creator>Zoli, Laura</creator><creator>Forzani, Teresio</creator><creator>Salerno-Uriarte, Jorge A</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>20051020</creationdate><title>Predictive significance for sudden death of microvolt-level T wave alternans in New York Heart Association class II congestive heart failure patients: a prospective study</title><author>Baravelli, Massimo ; Salerno-Uriarte, Diego ; Guzzetti, Daniela ; Rossi, Maria Cristina ; Zoli, Laura ; Forzani, Teresio ; Salerno-Uriarte, Jorge A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p209t-50081e9af8004a087d435f03a5561675ae9df4f00df629ac6902735206ac71033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Aged</topic><topic>Arrhythmias, Cardiac - etiology</topic><topic>Arrhythmias, Cardiac - physiopathology</topic><topic>Cardiomyopathies - classification</topic><topic>Cardiomyopathies - complications</topic><topic>Cardiomyopathies - therapy</topic><topic>Death, Sudden, Cardiac - etiology</topic><topic>Defibrillators, Implantable</topic><topic>Electrocardiography</topic><topic>Exercise Test</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Failure - classification</topic><topic>Heart Failure - complications</topic><topic>Heart Failure - therapy</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Myocardial Ischemia - complications</topic><topic>Myocardial Ischemia - physiopathology</topic><topic>Myocardial Ischemia - therapy</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Stroke Volume - physiology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baravelli, Massimo</creatorcontrib><creatorcontrib>Salerno-Uriarte, Diego</creatorcontrib><creatorcontrib>Guzzetti, Daniela</creatorcontrib><creatorcontrib>Rossi, Maria Cristina</creatorcontrib><creatorcontrib>Zoli, Laura</creatorcontrib><creatorcontrib>Forzani, Teresio</creatorcontrib><creatorcontrib>Salerno-Uriarte, Jorge A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baravelli, Massimo</au><au>Salerno-Uriarte, Diego</au><au>Guzzetti, Daniela</au><au>Rossi, Maria Cristina</au><au>Zoli, Laura</au><au>Forzani, Teresio</au><au>Salerno-Uriarte, Jorge A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive significance for sudden death of microvolt-level T wave alternans in New York Heart Association class II congestive heart failure patients: a prospective study</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>2005-10-20</date><risdate>2005</risdate><volume>105</volume><issue>1</issue><spage>53</spage><epage>57</epage><pages>53-57</pages><issn>0167-5273</issn><abstract>Sudden cardiac death (SDC) is responsible for approximately 60-70% of deaths in New York Heart Association (NYHA) class II congestive heart failure (CHF) patients. Recently, microvolt-level T wave alternans has been proposed as a new noninvasive tool to identify CHF patients at risk for SCD and ventricular tachycardia/fibrillation (VT/VF).
To determine the prognostic value of MTWA in NYHA class II patients.
Among 181 consecutive CHF patients with ischemic and nonischemic cardiomyopathy, 73 patients in NYHA class II with left ventricular ejection fraction <45% were selected and prospectively investigated. MTWA was determined during bicycle exercise testing. The study end point was defined as SCD, documented sustained VT/VF and appropriate implantable cardioverter defibrillator (ICD) shock.
MTWA was positive in 30 (41%) patients, negative in 26(36%) patients and indeterminate in 17 (23%) patients. During an average follow-up of 17.1+/-7.4 months, seven patients had an arrhythmic event in the MTWA positive group, whereas one and no events occurred in the indeterminate and negative group, respectively. From Kaplan-Meier univariate analysis and multivariate Cox analysis, MTWA was a significant arrhythmic risk stratifier (p=0.01 and p=0.03, respectively). Sensitivity, specificity, negative and positive predictive values of MTWA were 100%, 53%, 100% and 24%, respectively.
Our data suggest that MTWA is a promising predictor of arrhythmic events in NYHA class II CHF patients.</abstract><cop>Netherlands</cop><pmid>16207545</pmid><doi>10.1016/j.ijcard.2004.12.026</doi><tpages>5</tpages></addata></record> |
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subjects | Aged Arrhythmias, Cardiac - etiology Arrhythmias, Cardiac - physiopathology Cardiomyopathies - classification Cardiomyopathies - complications Cardiomyopathies - therapy Death, Sudden, Cardiac - etiology Defibrillators, Implantable Electrocardiography Exercise Test Female Follow-Up Studies Heart Failure - classification Heart Failure - complications Heart Failure - therapy Humans Male Middle Aged Multivariate Analysis Myocardial Ischemia - complications Myocardial Ischemia - physiopathology Myocardial Ischemia - therapy Prognosis Prospective Studies Risk Factors Stroke Volume - physiology Treatment Outcome |
title | Predictive significance for sudden death of microvolt-level T wave alternans in New York Heart Association class II congestive heart failure patients: a prospective study |
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