Abstract
Left ventricular (LV) hypertrophy and structural disease are associated with exaggerated repolarization dispersion and risk for cardiac arrest. We hypothesized that T-wave alternans (TWA) from the electrocardiogram, reflecting proarrhythmic repolarization dispersion, would increase with extent of eccentric LV hypertrophy and vary spatially with the distribution of myocardial scar. We studied 28 patients with coronary disease, systolic dysfunction, and nonsustained ventricular tachycardia. On echocardiography, 21 patients had wall motion abnormalities and 20 had LV hypertrophy (mass index > or =100 g/m(2)). TWA magnitude (voltage of alternation), which was computed spectrally during ventricular stimulation, varied linearly with LV mass index (p = 0.003). Spatially, positive TWA (magnitude > or =1.9 microV) in orthogonal electrocardiographic axes overlaid scar or wall motion abnormalities in corresponding echocardiographic segments (p <0.05 in x and y axes). After a follow-up of 35 +/- 13 months, positive TWA predicted the combined end point of death or sustained ventricular arrhythmias in all patients (p = 0.025), with a trend for those with echocardiographic LV hypertrophy (p = 0.058). In conclusion, in patients with systolic d...Continue Reading
References
Jun 1, 1990·Circulation·S G PrioriP J Schwartz
Jul 1, 1981·Circulation Research·E C Keung, R S Aronson
Jan 27, 1994·The New England Journal of Medicine·D S RosenbaumR J Cohen
Jun 1, 1996·The American Journal of Cardiology·J M CohnH Feigenbaum
Sep 1, 1996·Clinical Cardiology·R A KerenskyJ A Hill
Mar 15, 1997·Journal of the American College of Cardiology·J P SinghG Hart
Aug 19, 1997·Circulation·S J RialsP R Kowey
Nov 5, 1999·Circulation·S M NarayanJ M Smith
May 12, 2000·Journal of the American College of Cardiology·S M Narayan, J M Smith
Jan 11, 2000·Circulation Research·J M Pastore, D S Rosenbaum
Dec 29, 2000·Journal of the American College of Cardiology·M R GoldD S Rosenbaum
Mar 7, 2001·Hypertension·M G HennersdorfB E Strauer
Apr 9, 2001·Journal of Cardiovascular Electrophysiology·P A Boyden, H E ter Keurs
Jul 27, 2001·Journal of Cardiovascular Electrophysiology·Y Kon-NoK Shirato
Oct 5, 2001·Journal of the American College of Cardiology·L A PiresUNKNOWN Multicenter Unsustained Tachycardia Trial Investigators
Nov 6, 2002·Circulation·Alfred E BuxtonUNKNOWN MUSTT Investigators
Aug 22, 2003·Journal of Cardiovascular Electrophysiology·Richard L VerrierUNKNOWN ATRAMI Investigators
Mar 16, 2004·Circulation Research·Etienne J PruvotKenneth R Laurita
Mar 19, 2004·Journal of Cardiovascular Electrophysiology·Eric J RashbaMichael R Gold
May 7, 2004·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Ernesto PaolettiGiuseppe Cannella
Aug 4, 2004·Circulation·Peter J ZimetbaumMark E Josephson
Sep 29, 2004·Circulation·Daniel M BloomfieldJ Thomas Bigger
Feb 3, 2005·Pacing and Clinical Electrophysiology : PACE·M J Pekka RaatikainenUNKNOWN CARISMA Investigators
Apr 27, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Sanjiv M NarayanMichael E Cain
Jun 11, 2005·Journal of Cardiovascular Electrophysiology·Thomas KlingenhebenStefan H Hohnloser
Jan 18, 2006·Journal of the American College of Cardiology·Sanjiv M Narayan
Citations
Dec 14, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·John E Madias
Oct 28, 2008·Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences·Esther PueyoPablo Laguna
May 15, 2010·Circulation Journal : Official Journal of the Japanese Circulation Society·Valentina Otja PuntmannJohn Camm
Feb 25, 2014·The International Journal of Cardiovascular Imaging·Karin KraaierMarcoen F Scholten
Dec 26, 2012·Journal of Electrocardiology·John E Madias
Nov 11, 2011·Journal of Electrocardiology·John E Madias
Jul 28, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Raja J SelvarajVijay S Chauhan
Jun 5, 2007·Journal of Electrocardiology·John E Madias
Oct 7, 2009·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Laura BurattiniRoberto Burattini
May 30, 2008·Pacing and Clinical Electrophysiology : PACE·Daejoon AnhSanjiv M Narayan
Nov 8, 2011·Pacing and Clinical Electrophysiology : PACE·John E Madias
Jul 25, 2013·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Daniel J FriedmanPeter M Okin
Jul 3, 2013·Pacing and Clinical Electrophysiology : PACE·John E Madias
Apr 13, 2013·Journal of Cardiovascular Electrophysiology·John E Madias
Sep 5, 2013·IEEE Transactions on Bio-medical Engineering·Sofia-Maria DimaJohn Morgan
Oct 3, 2006·Journal of Electrocardiology·John E Madias
Nov 26, 2015·Journal of cardiology·Zhe ZhenKai-Hang Yiu
Mar 21, 2007·Pacing and Clinical Electrophysiology : PACE·Veronica CoxSanjiv M Narayan
Dec 13, 2006·Journal of Applied Physiology·Sanjiv M NarayanCarl F Edman
Apr 29, 2008·American Journal of Physiology. Heart and Circulatory Physiology·Donglin GuoGan-Xin Yan