Corrected QT Interval in Severe Aortic Stenosis: Clinical and Hemodynamic Correlates and Prognostic Impact

Tschumper, Maja; Weber, Lukas; Rickli, Hans; Seidl, Sebastian; Brenner, Roman; Buser, Marc; Ehl, Niklas F.; Jäger-Rhomberg, Franziska; Ammann, Peter; Maeder, Micha T.

doi:10.1016/j.amjmed.2020.05.035

Cited by 4 publications

(4 citation statements)

References 20 publications

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“…A waiver of consent was granted. We have previously reported on other aspects of the hemodynamics in this population [11][12][13][14][15][16][17].…”

Section: Study Populationmentioning

confidence: 82%

Hemodynamics Prior to Valve Replacement for Severe Aortic Stenosis and Pulmonary Hypertension during Long-Term Follow-Up

Weber¹,

Rickli²,

Haager³

et al. 2021

JCM

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(1) Background: Pulmonary hypertension after aortic valve replacement (AVR; post-AVR PH) carries a poor prognosis. We assessed the pre-AVR hemodynamic characteristics of patients with versus without post-AVR PH. (2) Methods: We studied 205 patients (mean age 75 ± 10 years) with severe AS (indexed aortic valve area 0.42 ± 0.12 cm2/m2, left ventricular ejection fraction 58 ± 11%) undergoing right heart catheterization (RHC) prior to surgical (70%) or transcatheter (30%) AVR. Echocardiography to assess post-AVR PH, defined as estimated systolic pulmonary artery pressure > 45 mmHg, was performed after a median follow-up of 15 months. (3) Results: There were 83/205 (40%) patients with pre-AVR PH (defined as mean pulmonary artery pressure (mPAP) ≥ 25 mmHg by RHC), and 24/205 patients (12%) had post-AVR PH (by echocardiography). Among the patients with post-AVR PH, 21/24 (88%) had already had pre-AVR PH. Despite similar indexed aortic valve area, patients with post-AVR PH had higher mPAP, mean pulmonary artery wedge pressure (mPAWP) and pulmonary vascular resistance (PVR), and lower pulmonary artery capacitance (PAC) than patients without. (4) Conclusions: Patients presenting with PH roughly one year post-AVR already had worse hemodynamic profiles in the pre-AVR RHC compared to those without, being characterized by higher mPAP, mPAWP, and PVR, and lower PAC despite similar AS severity.

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“…A waiver of consent was granted. We have previously reported on other aspects of the hemodynamics in this population [11][12][13][14][15][16][17].…”

Section: Study Populationmentioning

confidence: 82%

Hemodynamics Prior to Valve Replacement for Severe Aortic Stenosis and Pulmonary Hypertension during Long-Term Follow-Up

Weber¹,

Rickli²,

Haager³

et al. 2021

JCM

Self Cite

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“…For instance, it has been demonstrated that the progression of stenosis is conclusively correlated with ECG ST-T wave changes in a retrospective study on 29 patients 37 . Another study has recognized prolonged Q-T wave to be an in-dependent predictor of mortality among AS patients 38 . Furthermore, the occurrence of stenosis causes HRV parameters to change accordingly 39 , which will be scrutinized as a common characteristic among AS patients in this work.…”

Section: Methodsmentioning

confidence: 99%

Efficient detection of aortic stenosis using morphological characteristics of cardiomechanical signals and heart rate variability parameters

Shokouhmand

Aranoff²,

Driggin

et al. 2021

Sci Rep

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Recent research has shown promising results for the detection of aortic stenosis (AS) using cardio-mechanical signals. However, they are limited by two main factors: lacking physical explanations for decision-making on the existence of AS, and the need for auxiliary signals. The main goal of this paper is to address these shortcomings through a wearable inertial measurement unit (IMU), where the physical causes of AS are determined from IMU readings. To this end, we develop a framework based on seismo-cardiogram (SCG) and gyro-cardiogram (GCG) morphologies, where highly-optimized algorithms are designed to extract features deemed potentially relevant to AS. Extracted features are then analyzed through machine learning techniques for AS diagnosis. It is demonstrated that AS could be detected with 95.49–100.00% confidence. Based on the ablation study on the feature space, the GCG time-domain feature space holds higher consistency, i.e., 95.19–100.00%, with the presence of AS than HRV parameters with a low contribution of 66.00–80.00%. Furthermore, the robustness of the proposed method is evaluated by conducting analyses on the classification of the AS severity level. These analyses are resulted in a high confidence of 92.29%, demonstrating the reliability of the proposed framework. Additionally, game theory-based approaches are employed to rank the top features, among which GCG time-domain features are found to be highly consistent with both the occurrence and severity level of AS. The proposed framework contributes to reliable, low-cost wearable cardiac monitoring due to accurate performance and usage of solitary inertial sensors.

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“…The most commonly used for calculating QTc interval is the Bazett formula [7]. A prolongation of QTc interval is associated with increased cardiovascular (CV) mortality in patients with atrial fibrillation [8], coronary artery disease (CAD) [9], severe aortic stenosis [10], acute ischemic stroke [11], as well as PAD and diabetic foot [12]. In addition, a prolonged QTc was associated with all-cause mortality and SCD among patients on maintenance HD [13].…”

Section: Introductionmentioning

confidence: 99%

Corrected QT Interval and Outcomes of Dialysis Patients with Symptomatic Peripheral Artery Disease: A Prospective Cohort Study

Lin,

Chou,

Lin

et al. 2024

JCM

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Background: Peripheral artery disease (PAD) is common and associated with a higher risk of cardiovascular morbidity and mortality in dialysis patients. A longer corrected QT (QTc) interval has been associated with adverse cardiovascular events and mortality in the general population and patients with end-stage kidney disease. However, little evidence is available on the predictive value of QTc in dialysis patients with PAD. Methods: We conducted a prospective cohort study of 356 dialysis patients with symptomatic PAD undergoing endovascular therapy. We performed the resting 12-lead electrocardiogram (ECG) at baseline. Cox regression analyses were used to assess the association of QTc with all-cause mortality and major adverse cardiovascular events (MACEs), defined as non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death. Results: The mean age was 67.3 ± 11.5 years; 41.6% of participants were women. The median QTc was 471 (interquartile ranges 448–491) milliseconds (ms). During a median follow-up of 2.2 years, 188 (52.8%) patients died, and MACEs occurred in 119 (33.4%) patients. In multivariable-adjusted models, patients in tertile 3 of QTc levels had a significantly greater risk of all-cause mortality (hazard ratio [HR] 2.41, 95% confidence intervals [CI] 1.58–3.69) and MACEs (HR 1.90, 95% CI 1.15–3.13) than those in tertile 1. Similarly, each 10-ms increase in the baseline QTc predicted a higher risk of all-cause death (HR 1.15, 95% CI 1.09–1.21) and MACEs (HR 1.15, 95% CI 1.07–1.23). Conclusions: QTc prolongation was independently associated with adverse outcomes among dialysis patients with symptomatic PAD.

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Corrected QT Interval in Severe Aortic Stenosis: Clinical and Hemodynamic Correlates and Prognostic Impact

Cited by 4 publications

References 20 publications

Hemodynamics Prior to Valve Replacement for Severe Aortic Stenosis and Pulmonary Hypertension during Long-Term Follow-Up

Hemodynamics Prior to Valve Replacement for Severe Aortic Stenosis and Pulmonary Hypertension during Long-Term Follow-Up

Efficient detection of aortic stenosis using morphological characteristics of cardiomechanical signals and heart rate variability parameters

Corrected QT Interval and Outcomes of Dialysis Patients with Symptomatic Peripheral Artery Disease: A Prospective Cohort Study

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