Sex Differences in Repolarization Markers: Telemonitoring for Chronic Heart Failure Patients

Abstract

Aging and chronic heart failure (CHF) are responsible for the temporal inhomogeneity of the electrocardiogram (ECG) repolarization phase. Recently, some short period repolarization–dispersion parameters have been proposed as markers of acute decompensation and of mortality risk in CHF patients. Some important differences in repolarization between sexes are known, but their impact on ECG markers remains unstudied. The aim of this study was to evaluate possible differences between men and women in ECG repolarization markers for the telemonitoring of CHF patients. Method: 5 min ECG recordings were collected to assess the mean and standard deviation (SD) of the following variables: QT end (QTe), QT peak (QTp), and T peak to T end (Te) in 215 decompensated CHF (age range: from 49 to 103 years). Thirty-day mortality and high levels of NT-pro BNP (<75 percentile) were considered markers of decompensated CHF. Results: A total of 34 patients (16%) died during the 30-day follow-up, without differences between sexes. Women showed a more preserved ejection fraction and higher LDL and total cholesterol levels. Among female patients, implantable cardioverter devices, statins, and antiplatelet agents were less used. Data for Te mean showed increased values among deceased men and women compared to survival, but TeSD was shown to be the most reliable marker for CHF reacutization in both sexes. Conclusion: TeSD could be considered a risk factor for CHF worsening and complications for female and male patients, but different cut offs should be taken into account. (ClinicalTrials.gov number, NCT04127162.)

Artificial Intelligence Applied to Electrical and Non-Invasive Hemodynamic Markers in Elderly Decompensated Chronic Heart Failure Patients

“…The major finding of the present study was confirmation of the association of the Te interval with an increased risk of in-hospital mortality in decompensated patients [17][18][19][20]22,23,43]. Secondly, a significant difference was not observed in ECG repolarization and non-invasive hemodynamic data between HFrEF and HFmrEF patients (Tables 2 and 3).…”

“…In particular, it has been previously observed that an increase in the Tpeak-Tend (Te) interval was a risk factor for total and cardiovascular mortality [14][15][16]. An increase in this interval and its short-period temporal dispersion was associated with mortality and decompensation in patients with acute CHF [17][18][19][20][21][22][23]. Finally, non-invasive hemodynamic parameters were studied based on bioimpedance to assess the possibility of monitoring clinical improvements in these patients [19,[24][25][26][27].…”