Periodic repolarization dynamics as pbkp_redictor of risk for sudden cardiac death in chronic heart failure patients
Abstract:
The two most common modes of death among chronic heart failure (CHF) patients are sudden cardiac death (SCD) and pump failure death (PFD). Periodic repolarization dynamics (PRD) quantifies low-frequency oscillations in the T wave vector of the electrocardiogram (ECG) and has been postulated to reflect sympathetic modulation of ventricular repolarization. This study aims to evaluate the prognostic value of PRD to pbkp_redict SCD and PFD in a population of CHF patients. 20-min high-resolution (1000 Hz) ECG recordings from 569 CHF patients were analyzed. Patients were divided into two groups, PRD + and PRD -, corresponding to PRD values above and below the optimum cutoff point of PRD in the study population. Univariate Cox regression analysis showed that SCD risk in the PRD + group was double the risk in the PRD - group [hazard ratio (95% CI) 2.001 (1.127–3.554), p < 0.05]. The combination of PRD with other Holter-based ECG indices, such as turbulence slope (TS) and index of average alternans (IAA), improved SCD pbkp_rediction by identifying groups of patients at high SCD risk. PFD could be pbkp_redicted by PRD only when combined with TS [hazard ratio 2.758 (1.572–4.838), p < 0.001]. In conclusion, the combination of PRD with IAA and TS can be used to stratify the risk for SCD and PFD, respectively, in CHF patients.
Año de publicación:
2021
Keywords:
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Tipo de documento:
Article
Estado:
Acceso abierto
Áreas de conocimiento:
- Enfermedad cardiovascular
Áreas temáticas:
- Enfermedades