Impaired repolarization parameters may predict fatal ventricular arrhythmias in patients with hypertrophic cardiomyopathy (from the CILICIA Registry)

Güner, Ahmet; Kalçık, Macit; Çelık, Mehmet; Uzun, Fatih; Çizgici, Ahmet Yaşar; Ağuş, Hicaz Zencirkıran; Aslan, Serkan; Güner, Ekrem; Ulutaş, Ahmet Emir; Bayam, Emrah; Kalkan, Mehmet

doi:10.1016/j.jelectrocard.2020.10.009

Cited by 9 publications

(13 citation statements)

References 34 publications

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“…In adults with non-ischemic dilated cardiomyopathies, a greater QRS-T angle is a risk factor for ventricular arrhythmias, re-hospitalizations due to heart failure, and increased mortality [ 2 , 3 , 4 ]. A similar observation was made in patients with hypertrophic cardiomyopathy (HCM) in whom a wider QRS-T angle was associated with greater risk for ventricular arrhythmia [ 5 , 6 ]. Furthermore, an association between some genetic mutations (LZTR1, LGMD, SCN5a) and ion channel abnormalities of the myocytes was shown for cells with dilated and hypertrophic cardiomyopathies [ 7 , 8 , 9 ].…”

Section: Introductionsupporting

confidence: 52%

Electrocardiographic Parameters Associated with Adverse Outcomes in Children with Cardiomyopathies

Łuczak-Woźniak

Obsznajczyk²,

Niszczota³

et al. 2022

JCM

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Cardiomyopathies have a low prevalence in children and thus may lead to malignant ventricular arrhythmias or the progression of heart failure, resulting in death. In adults, the QRS-T angle derived from ECG has been associated with adverse outcomes in patients with hypertrophic and dilated cardiomyopathies. We aimed to assess the electrocardiographic parameters, including QRS-T angle, associated with adverse cardiac events in children with cardiomyopathies. Forty-two children with cardiomyopathies were included in this study: 19 with dilated cardiomyopathy, 17 with hypertrophic cardiomyopathy, and 6 with left ventricular non-compaction. Additionally, 19 control subjects were recruited. In terms of ECG parameters, the QRS-T angle was significantly greater among patients with adverse outcomes compared to patients without the end points of the study (133° vs. 65°, p < 0.001). On Kaplan–Meier survival curves, QRS-T angle > 120°, increased serum concentrations of NT-proBNP and troponin I levels as well as greater NYHA or Ross scale were associated with the greatest risk of unfavorable outcome. The QRS-T angle appears to be a valuable component of 12-lead ECG interpretation, and might be helpful in outlining patients with the greatest cardiovascular risk. Additionally, serum biomarkers such as NT-proBNP (p = 0.003) and troponin (p < 0.001) are useful in outlining patients with the worst survival.

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Section: Introductionsupporting

confidence: 52%

Electrocardiographic Parameters Associated with Adverse Outcomes in Children with Cardiomyopathies

Łuczak-Woźniak

Obsznajczyk²,

Niszczota³

et al. 2022

JCM

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“…Although Tp-e interval and Tp-e/QTc ratio are well-studied ECG parameters in cardiovascular diseases [8][9][10][11], there is no study regarding Tp-e interval and Tp-e/QTc ratio in CCAA patients. These parameters indirectly reflect ventricular repolarization abnormalities, and also may be related to arrhythmic events in the CCAA population.…”

Section: Discussionmentioning

confidence: 99%

Relationship between impaired repolarization parameters and poor cardiovascular clinical outcomes in patients with potentially serious coronary artery anomalies

Kalkan

Güner

Kalçık

et al. 2021

Coronary Artery Disease

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Background Congenital coronary artery anomalies (CCAAs) have the potential for life-threatening complications, including malignant ventricular arrhythmias and sudden cardiac death (SCD). In this study, we aimed to evaluate the relationship between impaired repolarization parameters and poor cardiovascular clinical outcomes in patients with potentially serious CCAAs.Methods This retrospective study included 85 potentially serious CCAA patients (mean age: 54.7 ± 13.6 years; male:44) who were diagnosed with conventional and coronary computed tomography angiography (CCTA). All patients underwent transthoracic echocardiography and 12-lead surface electrocardiography. Cardiac events were defined as sustained ventricular tachycardia or fibrillation, syncope, cardiac arrest and SCD. ResultsThe presence of interarterial course (IAC) was confirmed by CCTA in 37 (43.5%) patients. During a median follow-up time of 24 (18-50) months, a total of 11 (12.9%) patients experienced cardiac events. The presence of IAC was significantly more frequent and Tp-e interval, Tp-e/QTc ratio and frontal QRS/T angle (fQRSTa) were significantly greater in patients with poor clinical outcomes. Moreover, the presence of IAC, high Tp-e/ QTc ratio and high fQRSTa were found to be independent predictors of poor clinical outcomes and decreased longterm cardiac event-free survival in these patients. A net reclassification index was +1.0 for the Tp-e/QTc ratio and +1.3 for fQRSTa which were confirmable for additional predictability of these repolarization abnormalities Conclusion Impaired repolarization parameters, including wider fQRSTa, prolonged Tp-e interval, and increased Tp-e/QTc ratio, and IAC may be associated with poor cardiovascular clinical outcomes in potentially serious CCAA patients. Coron Artery Dis 33: e27-e36

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“…9 Frontal QRS-T angle (fQRSTa) is defi ned as the absolute diff erence between QRS and T wave axes on 12-lead ECG and is considered a parameter for ventricular repolarization. [10][11][12] Besides, fQRSTa helps for estimating clinical events such as the development of fatal ventricular arrhythmias or sudden death in cardiovascular diseases. 10,12,13 Th e main purpose here was to defi ne the correlation between diff erent LV patterns and fQRSTa in patients with HT.…”

Section: Introductionmentioning

confidence: 99%

The Status of Frontal QRS-T Angle in Hypertensive Patients with Different Left Ventricular Geometry

Gürbak¹,

Güler²,

Panç³

et al. 2021

Sakarya Medical Journal

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Objective Assessing left ventricular (LV) structure and function gives information on cardiovascular morbidity and mortality, making it essential for evaluating hypertensive heart disease. Frontal QRS-T angle (fQRSTa) is a novel approach to quantify the heterogeneity between myocardial depolarization and repolarization. The main purpose of the present study was to define the correlation between different LV geometric patterns and fQRSTa in patients with hypertension (HT). Materials and Methods273 patients with hypertension admitted to the cardiology out-patient clinic were enrolled consecutively. All patients were evaluated by transthoracic echocardiography and classified into three groups based on LV hypertensive geometry as normal geometry (group 0), concentric remodeling (group 1), and concentric or eccentric hypertrophy (group 2). The fQRSTa was defined as the absolute angle difference between the frontal plane QRS axis and T wave axis.Results Compared with group 0, fQRSTa was higher in group 1 (12 [6 -19] vs. 17 [12 -24], p=0.023) and group 2 (12 [6 -19] vs. 39 [28 -54], p<0.001). Also, fQRSTa was higher in group 2 than group 1 (p<0.001). Correlation analysis revealed a significant correlation between fQRSTa and LV geometry (r=0.525, p<0.001). Multiple linear regression analysis revealed that fQRSTa was independently correlated with Em to Am ratio (β=0.104, p=0.045), left ventricle mass index (β=0.342, p<0.001), QTc (β=0.194, p<0.001), and LV geometry (β=0.257, p<0.001).Conclusion Patients with LVH were found to have wider fQRSTa and longer QT duration than those with normal ventricles or concentric remodeling. Keywords Left ventricular geometry; frontal QRS-T angle; hypertension ÖzAmaç Hipertansif kalp hastalığının değerlendirilmesinde sol ventrikül (SV) yapısının ve fonksiyonunun incelenmesi, kardiyovasküler morbidite ve mortalite hakkında önemli bilgiler sağlar. Frontal QRS-T açısı (fQRSTa), miyokardiyal depolarizasyon ve repolarizasyon arasındaki heterojenliği ölçmek için kullanılan yeni bir yöntemdir. Bu çalışmanın temel amacı, hipertansiyonlu (HT) hastalarda farklı SV geometrik paternleri ile fQRSTa arasındaki ilişkiyi incelemektir. Gereç ve YöntemleKardiyoloji polikliniğine başvuran ardışık 273 hipertansiyon hastası çalışmaya dahil edildi. Tüm hastalar transtorasik ekokardiyografi ile değerlendirildi ve SV geometrik yapısına göre normal geometri (grup 0), konsantrik yeniden şekillenme (grup 1) ve konsantrik veya eksantrik hipertrofi (grup 2) olarak üç gruba ayrıldı. fQRSTa, frontol düzlem QRS aksı ile T dalga aksı arasındaki mutlak açı farkı olarak tanımlandı.

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Impaired repolarization parameters may predict fatal ventricular arrhythmias in patients with hypertrophic cardiomyopathy (from the CILICIA Registry)

Cited by 9 publications

References 34 publications

Electrocardiographic Parameters Associated with Adverse Outcomes in Children with Cardiomyopathies

Electrocardiographic Parameters Associated with Adverse Outcomes in Children with Cardiomyopathies

Relationship between impaired repolarization parameters and poor cardiovascular clinical outcomes in patients with potentially serious coronary artery anomalies

The Status of Frontal QRS-T Angle in Hypertensive Patients with Different Left Ventricular Geometry

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