Relationships between the T-peak to T-end interval, ventricular tachyarrhythmia, and death in left ventricular systolic dysfunction

Morin, Daniel P.; Saad, Marc N.; Shams, Omar; Owen, Joseph S.; Xue, Joel; Abi‐Samra, Freddy; Khatib, Sammy; Nelson-Twakor, Onajefe S.; Milani, Richard V.

doi:10.1093/europace/eur426

Cited by 60 publications

(54 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…More importantly, ECG data obtained from radiotelemetry recording demonstrated that in vivo transfection of Ca v 2.2‐α shRNA into AVG neurons not only increased the QT interval, QTc interval, QTd, QTcd, and Tpe but also induced a spontaneous ventricular tachyarrhythmia in conscious rats (Figures 6 and 7). It has been found that prolongation of the QT and QTc intervals, increase of the QTd and QTcd (a marker of spatial heterogeneity of ventricular repolarization), and prolonged Tpe (a marker of transmural dispersion of ventricular repolarization) are associated with increased risk of malignant ventricular arrhythmias and sudden cardiac death 49, 50, 51, 52. The results in the present study provide direct evidence that blunted ventricular vagal activity increases the susceptibility to ventricular arrhythmias and induces ventricular arrhythmias.…”

Section: Discussionsupporting

confidence: 63%

Reduced N‐Type Ca ²⁺ Channels in Atrioventricular Ganglion Neurons Are Involved in Ventricular Arrhythmogenesis

Zhang

Cao

et al. 2018

JAHA

View full text Add to dashboard Cite

BackgroundAttenuated cardiac vagal activity is associated with ventricular arrhythmogenesis and related mortality in patients with chronic heart failure. Our recent study has shown that expression of N‐type Ca2+ channel α‐subunits (Cav2.2‐α) and N‐type Ca2+ currents are reduced in intracardiac ganglion neurons from rats with chronic heart failure. Rat intracardiac ganglia are divided into the atrioventricular ganglion (AVG) and sinoatrial ganglion. Ventricular myocardium receives projection of neuronal terminals only from the AVG. In this study we tested whether a decrease in N‐type Ca2+ channels in AVG neurons contributes to ventricular arrhythmogenesis.Methods and ResultsLentiviral Cav2.2‐α shRNA (2 μL, 2×107 pfu/mL) or scrambled shRNA was in vivo transfected into rat AVG neurons. Nontransfected sham rats served as controls. Using real‐time single‐cell polymerase chain reaction and reverse‐phase protein array, we found that in vivo transfection of Cav2.2‐α shRNA decreased expression of Cav2.2‐α mRNA and protein in rat AVG neurons. Whole‐cell patch‐clamp data showed that Cav2.2‐α shRNA reduced N‐type Ca2+ currents and cell excitability in AVG neurons. The data from telemetry electrocardiographic recording demonstrated that 83% (5 out of 6) of conscious rats with Cav2.2‐α shRNA transfection had premature ventricular contractions (P<0.05 versus 0% of nontransfected sham rats or scrambled shRNA‐transfected rats). Additionally, an index of susceptibility to ventricular arrhythmias, inducibility of ventricular arrhythmias evoked by programmed electrical stimulation, was higher in rats with Cav2.2‐α shRNA transfection compared with nontransfected sham rats and scrambled shRNA‐transfected rats.ConclusionsA decrease in N‐type Ca2+ channels in AVG neurons attenuates vagal control of ventricular myocardium, thereby initiating ventricular arrhythmias.

show abstract

Section: Discussionsupporting

confidence: 63%

Reduced N‐Type Ca ²⁺ Channels in Atrioventricular Ganglion Neurons Are Involved in Ventricular Arrhythmogenesis

Zhang

Cao

et al. 2018

JAHA

View full text Add to dashboard Cite

show abstract

“…It was demonstrated that Tp-e/QT ratio was a strong predictor of sudden cardiac death (28) and was significantly elevated in those who suffered malignant ventricular arrhythmias (29). In accordance with our study, Tun et al demonstrated that Tp-e was significantly higher in the end-stage renal disease group than in the control group (30).…”

Section: Türk Nefroloji Diyaliz Ve Transplantasyon Dergisi Turkish Nesupporting

confidence: 90%

Tp-e/QT and Tp-e/QTc Ratio in Hemodialysis and Peritoneal Dialysis Patients

Güçlü¹,

Sipahioğlu²,

Icli³

et al. 2016

Turk Neph Dial Transpl

View full text Add to dashboard Cite

OBJECTIVE: Sudden cardiac death and risk of arrhythmia are higher in patients with ESRD. Tp-e/ QT, and Tp-e/QTc are novel and more reliable indexes of ventricular arrhythmogenesis and sudden cardiac death than QTc. The aim of this study was to assess ventricular repolarization in patients with hemodialysis and peritoneal dialysis by using the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio. MATERIAL and METHODS:A total of 35 healthy controls, 92 hemodialysis patients, and 104 peritoneal dialysis patients were enrolled in the study. The Tp-e interval, Tp-e/QT, and Tp-e/QTc ratio were calculated from the ECGs of the individuals and compared among groups. RESULTS:QT value was significantly higher in hemodialysis group compared with peritoneal dialysis group (p<0.001) and control group (p<0.001). However a difference was not found comparing QT values between peritoneal dialysis and control groups. Tp-e, Tp-e/QTc, Tp-e/QT, and QTc values were significantly higher in hemodialysis and peritoneal dialysis group comparing to control group. However a statistically significant difference was not found while comparing QTc values between peritoneal dialysis and control groups (p:0.081). When all patients of ESRD without DM were compared with the control group, Tp-e, Tp-e/QTc, Tp-e/QT, and QTc values were found significantly higher than the healthy control group. The values of Tp-e/QT (p<0.001 r:0.314) and Tp-e/QTc (p:0.018 r:0,187) in all patients with kidney disease were found to show positive correlation with duration of dialysis (month). CONCLUSION:This is the first known study that shows Tp-e/Q, and Tp-e/QTc are higher in hemodialysis and peritoneal dialysis patients. KEy wORDS:Tp-e/QT, Tp-e/QTc, Tp-e, QTc, Dialysis Öz AMAÇ: Ani kardiyak ölüm ve aritmi riski son dönem böbrek yetmezliği hastalarında yüksektir. Tp-e/ QT, ve Tp-e/QTc' nin ventriküler aritmogenezisi ve ani kardiyak ölümü göstermede QTc' den daha değerli olduğu gösterilmiştir. Çalışmada amacımız hemodiyaliz ve periton diyalizi hastalarında Tp-e intervali, Tp-e/QT ve Tp-e/QTc oranını kullanarak ventriküler repolarizasyonu değerlendirmektir. GEREÇ ve yÖNTEMLER:35 sağlıklı kontrol, 92 hemodiyaliz hastası, ve 104 periton diyalizi hastası çalışmaya dahil edildi. Bütün hastaların elektrokardiyografileri çekildi. Tp-e interval, Tp-e/QT ve Tp-e/ QTc oranı elektrokardiyografiden elde edilen verilerle hesaplandı ve gruplar arasında karşılaştırıldı. BULGULAR:QT hemodiyaliz hastalarında periton diyalizi hastalarına (p<0,001) ve sağlıklı kontrollere (p<0,001) göre yüksek saptandı. Ancak QT periton diyalizi hastalarında sağlıklı kontrollere göre anlamlı fark saptanmadı. QTc, Tp-e, Tp-e/QT, ve Tp-e/QTc hemodiyaliz ve periton diyalizi hastalarında sağlıklı kontrollere göre anlamlı yüksek tespit edildi. Bununla birlikte periton diyalizi ve kontrol grupları arasında QTc değerleri arasında farklılık tespit edilmedi (p:0,081). Diyabetik olmayan bütün son dönem böbrek yetmezliği hastaları sağlıklı kontrollerle karşılaştırıldığında QTc, Tp-e, Tp-e/ QT, ve Tp-e/QTc sağlıkl...

show abstract

“…In patients undergoing percutaneous coronary intervention for STelevation myocardial infarction, a longer pre-PCI (but not post-PCI) Tp-e predicted all-cause one-year mortality (12). In patients with left ventricular systolic dysfunction and ICD therapy, Tp-e predicted both appropriate ICD therapy for ventricular tachyarrhythmia and overall mortality, even after correction for other independent predictors (14).…”

Section: Discussionmentioning

confidence: 99%

“…The TIMI frame count method is a simple, reproducible, objective, and quantitative index of coronary flow velocity (14). The TIMI frame count was determined for each major coronary artery in each patient according to the method that was first described by Gibson et al (14).…”

Section: Documentation Of Coronary Slow Flowmentioning

confidence: 99%

See 1 more Smart Citation

The Relationship between Tpeak-end Interval Duration and Tpeak-end/QT Ratio, and Arrhythmias in Patients with Coronary Slow Flow

Şen¹,

Yılmaz²,

Özcan³

et al. 2016

Int Cardiovasc Res J

View full text Add to dashboard Cite

A B S T R A C TBackground: Coronary Slow Flow (CSF) is described as delayed opacification of the distal vasculature and angiographically Normal Coronary Arteries (NCA). Numerous studies have suggested that the interval from the peak to the end of electrocardiographic T wave (Tp-e) may correspond to transmural dispersion of repolarization and that increased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. Objectives: The present study aimed to evaluate ventricular repolarization in patients with CSFby using Tp-e interval and Tp--e/QT ratio. Patients and Methods: This study was conducted on electrocardiographic parameters of 100 patients with angiographically proven NCA with CSF in all three coronary arteries and 100 patients with NCA without CSF. The patients were followed up for arrhythmias and clinical events. Results: Tp-e tail interval (120 ± 5.5 msn, 101 ± 3.9 msn; P < 0.001), Tp-e tangent interval (99 ± 4.0 msn, 78 ± 3.0 msn, P < 0.001), Tp-e tail/QT ratio (0.31 ± 0.004, 0.26 ± 0.003, P < 0.001), and Tp-e tangent/QT ratio (0.25 ± 0.003, 0.19 ± 0.003, P < 0.001) were significantly higher in the CSF patients compared to the NCA group. Rhythm holter analyses also showed that ventricular extrasystoles were higher (157 ± 22.5, 87 ± 11.9, P = 0.002) in the CSF group compared to the NCA group. Conclusions: Tp-e interval and Tp-e/QT ratio were significantly higher in the patients with CSF compared to the NCA group.

show abstract

Relationships between the T-peak to T-end interval, ventricular tachyarrhythmia, and death in left ventricular systolic dysfunction

Abstract: In patients with left ventricular systolic dysfunction and an implanted ICD, Tpe(c) independently predicts both ventricular tachyarrhythmia and overall mortality.

Cited by 60 publications

References 29 publications

Reduced N‐Type Ca ²⁺ Channels in Atrioventricular Ganglion Neurons Are Involved in Ventricular Arrhythmogenesis

Reduced N‐Type Ca ²⁺ Channels in Atrioventricular Ganglion Neurons Are Involved in Ventricular Arrhythmogenesis

Tp-e/QT and Tp-e/QTc Ratio in Hemodialysis and Peritoneal Dialysis Patients

The Relationship between Tpeak-end Interval Duration and Tpeak-end/QT Ratio, and Arrhythmias in Patients with Coronary Slow Flow

Contact Info

Product

Resources

About

Relationships between the T-peak to T-end interval, ventricular tachyarrhythmia, and death in left ventricular systolic dysfunction

Abstract: In patients with left ventricular systolic dysfunction and an implanted ICD, Tpe(c) independently predicts both ventricular tachyarrhythmia and overall mortality.

Cited by 60 publications

References 29 publications

Reduced N‐Type Ca 2+ Channels in Atrioventricular Ganglion Neurons Are Involved in Ventricular Arrhythmogenesis

Reduced N‐Type Ca 2+ Channels in Atrioventricular Ganglion Neurons Are Involved in Ventricular Arrhythmogenesis

Tp-e/QT and Tp-e/QTc Ratio in Hemodialysis and Peritoneal Dialysis Patients

The Relationship between Tpeak-end Interval Duration and Tpeak-end/QT Ratio, and Arrhythmias in Patients with Coronary Slow Flow

Contact Info

Product

Resources

About

Reduced N‐Type Ca ²⁺ Channels in Atrioventricular Ganglion Neurons Are Involved in Ventricular Arrhythmogenesis

Reduced N‐Type Ca ²⁺ Channels in Atrioventricular Ganglion Neurons Are Involved in Ventricular Arrhythmogenesis