Quantitative T-wave morphology assessment from surface ECG is linked with cardiac events risk in genotype-positive KCNH2 mutation carriers with normal QTc values

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Cortez, DanielLund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,University of Minnesota Masonic Children's Hospital,University of Minnesota (författare)

Quantitative T-wave morphology assessment from surface ECG is linked with cardiac events risk in genotype-positive KCNH2 mutation carriers with normal QTc values

Artikel/kapitelEngelska2019

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2019-10-16
Wiley,2019

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LIBRIS-ID:oai:lup.lub.lu.se:8b7d4ce0-a4bc-443b-a22f-fa3ef7dd86ee
https://lup.lub.lu.se/record/8b7d4ce0-a4bc-443b-a22f-fa3ef7dd86eeURI
https://doi.org/10.1111/jce.14210DOI

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Språk:engelska
Sammanfattning på:engelska

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Introduction: Long QT syndrome (LQTS) mutation carriers have elevated the risk of cardiac events even in the absence of QTc prolongation; however, mutation penetrance in patients with normal QTc may be reflected in abnormal T-wave shape, particularly in KCNH2 mutation carriers. We aimed to assess whether the magnitude of a three-dimensional T-wave vector (TwVM) will identify KCNH2-mutation carriers with normal QTc at risk for cardiac events. Methods: Adult LQT2 patients with QTc < 460 ms in men and <470 ms in women (n = 113, age 42 ± 16 years, 43% male) were compared with genotype-negative family members (n = 1007). The TwVM was calculated using T-wave amplitudes in leads V6, II, and V2 as the square root of (TV62 + TII2 + (0.5*TV2)2). Cox regression analysis adjusted for gender and time-dependent beta-blocker use was performed to assess cardiac event (CE) risk, defined as syncope, aborted cardiac arrest, implantable cardioverter-defibrillator therapy, or sudden death. Results: Dichotomized by median of 0.30 mV, lower TwVM was associated with elevated CE risk compared to those with high TwVM (HR = 2.95, 95% CI, 1.25-6.98, P =.014) and also remained significant after including sex and time-dependent beta-blocker usage in the Cox regression analysis (HR = 2.64, 95% CI, 1.64-4.24, P <.001). However, these associations were found only in women but not in men who had low event rates. Conclusion: T-wave morphology quantified as repolarization vector magnitude using T-wave amplitudes retrieved from standard 12-lead electrocardiogram predicts cardiac events risk in LQT2 women and appears useful for risk stratification of KCNH2-mutation carriers without QTc prolongation.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
cardiac events
long QT syndrome
T-wave vector magnitude

Biuppslag (personer, institutioner, konferenser, titlar ...)

Zareba, WojciechUniversity of Rochester Medical Center (författare)
McNitt, ScottUniversity of Rochester Medical Center (författare)
Polonsky, BronislavaUniversity of Rochester Medical Center (författare)
Rosero, Spencer Z.University of Rochester Medical Center (författare)
Platonov, Pyotr G.Lund University,Lunds universitet,Electrocardiology Research Group - CIEL,Forskargrupper vid Lunds universitet,Lund University Research Groups(Swepub:lu)kard-ppl (författare)
KardiologiSektion II (creator_code:org_t)

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Ingår i:Journal of Cardiovascular Electrophysiology: Wiley30:12, s. 2907-29131045-38731540-8167

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Av författaren/redakt...: Cortez, Daniel; Zareba, Wojciech; McNitt, Scott; Polonsky, Bronis ...; Rosero, Spencer ...; Platonov, Pyotr ...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

Artiklar i publikationen: Journal of Cardi ...

Av lärosätet: Lunds universitet

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