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
Hauptverfasser: Baravelli, Massimo, Salerno-Uriarte, Diego, Guzzetti, Daniela, Rossi, Maria Cristina, Zoli, Laura, Forzani, Teresio, Salerno-Uriarte, Jorge A
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container_end_page 57
container_issue 1
container_start_page 53
container_title International journal of cardiology
container_volume 105
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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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 &lt;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. 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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. 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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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