Assessment of Tp-Te Interval and Tp-Te/Qt Ratio in Patients with Aortic Aneurysm
DOI:
https://doi.org/10.3889/oamjms.2019.191Keywords:
Tp-Te interval, Transmural dispersion, Tp-Te/QT, Aortic AneurysmAbstract
BACKGROUND: Arrhythmic disorders in the aortic aneurysm (AA) have been rarely reported.
AIM: The study aimed to assess the repolarisation indices of ventricular arrhythmia (VA) (mainly Tp-Te interval and Tp-Te/QT ratio) in patients with AA.
METHODS: A group of 98 patients with AA and 75 patients as control were recruited. Many of indices of ventricular arrhythmia were assessed.
RESULTS: Many of indices like QT, QTc, QTpc, Tp-Te/QT, Tp-Te/QTc, Tp-Tec/QTc, S-Tp, S-Tpc, S-Te, S-Tec and fQRS were found to be significantly different in AA group (for all P < 0.05). However, QTp, mean Tp-Te and Tp-Tec were not found different (for all P < 0.05). Aortic diameter (Ao-D) was found to have a positive correlation with QTc, QTpc, S-Tp, S-Tpc, S-Te, S-Tec, fQRS (for all P < 0,05) and negative correlation withTp-Te/QT (P = 0.047). The best cut-off level for prediction of Tp-Te ≥100 ms was found the Ao-D > 43.5 mm in ROC analysis (AUC: 0.69; P = 0.151) with sensitivity 60% and specificity 79.6%.
CONCLUSIONS: Although our study did not find any differences for mean Tp-Te interval between groups, many of other indexes of TDR were found to be significantly different. Ao-D was found to have significant correlations with many indices.
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Erbel R, Aboyans V, Boileau C. et al. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases. European Heart Journal. 2014; 35:2873–2926. https://doi.org/10.1093/eurheartj/ehu281 PMid:25173340
Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey DE, Eagle KA, Hermann LK, Isselbacher EM, Kazerooni EA, Kouchoukos NT. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease. Journal of the American College of Cardiology. 2010; 55(14):e27-219. https://doi.org/10.1016/j.jacc.2010.02.015 PMid:20359588
Townsend R. R, Wilkinson I. B, Schiffrin E. L.et al. Recommendations for Improving and Standardizing Vascular Research on Arterial Stiffness: A Scientific Statement from the American Heart Association. Hypertension. 2015; 66(3):698–722. https://doi.org/10.1161/HYP.0000000000000033 PMid:26160955 PMCid:PMC4587661
Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. Journal of the American College of Cardiology. 2010; 55(13):1318-27. https://doi.org/10.1016/j.jacc.2009.10.061 PMid:20338492
Lau DH, Middeldorp ME, Brooks AG, Ganesan AN, Roberts-Thomson KC, Stiles MK, Leong DP, Abed HS, Lim HS, Wong CX, Willoughby SR. Aortic stiffness in lone atrial fibrillation: a novel risk factor for arrhythmia recurrence. PloS one. 2013; 8(10):e76776. https://doi.org/10.1371/journal.pone.0076776 PMid:24098560 PMCid:PMC3789695
Palmeira MM, Ribeiro HY, Lira YG, Neto FO, da Silva Rodrigues IA, Gadelha MS, do Carmo YS. Aortic aneurysm with complete atrioventricular block and acute coronary syndrome. BMC research notes. 2016; 9(1):257. https://doi.org/10.1186/s13104-016-2050-2 PMid:27142198 PMCid:PMC4855812
Lionakis N, Moyssakis I, Gialafos E.et al.Aortic Dissection and Third-Degree Atrioventricular Block in a Patient With a Hypertensive Crisis. J Clin Hypertens. 2008; 10:69–72. https://doi.org/10.1111/j.1524-6175.2007.07202.x
Yan G. X, Antzelevitch C. Cellular Basis for the Normal T Wave and the Electrocardiographic Manifestations of the Long-QT Syndrome. Circulation. 1998; 98:1928-1936. https://doi.org/10.1161/01.CIR.98.18.1928
Akar F. G, Yan G. X, Antzelevitch C.et al. Unique Topographical Distribution of M Cells Underlies Reentrant Mechanism of Torsade de Pointes in the Long-QT Syndrome. Circulation. 2002; 105:1247- 1253. https://doi.org/10.1161/hc1002.105231 PMid:11889021
Chua KCM, Rusinaru C, Reinier K. et al. Tpeak-to-Tend interval corrected for heart rate: A more precise measure of increased sudden death risk? Towards an improved sudden death risk prediction. Heart Rhythm. 2016; 13(11):2181–2185. https://doi.org/10.1016/j.hrthm.2016.08.022 PMid:27523774 PMCid:PMC5100825
Antzelevitch C, Viskin S, Shimizu W. et al. Does Tpeak-Tend Provide an Index of Transmural Dispersion of Repolarization? Heart Rhythm. 2007; 4(8):1114–1119. https://doi.org/10.1016/j.hrthm.2007.05.028 PMid:17675094 PMCid:PMC1994816
Morin DP, Saad MN, Shams OF, Owen JS, Xue JQ, Abi-Samra FM, Khatib S, Nelson-Twakor OS, Milani RV. Relationships between the T-peak to T-end interval, ventricular tachyarrhythmia, and death in left ventricular systolic dysfunction. Europace. 2012; 14(8):1172-9. https://doi.org/10.1093/europace/eur426 PMid:22277646
Panikkath R, Reinier K, Uy-Evanado A. et al. Prolonged Tpeak-to-Tend Interval on the Resting ECG Is Associated With Increased Risk of Sudden Cardiac Death. Circ Arrhythm Electrophysiol. 2011; 4:441-447. https://doi.org/10.1161/CIRCEP.110.960658 PMid:21593198 PMCid:PMC3157547
Haarmark C, Hansen PR, Vedel-Larsen E. et al.The prognostic value of the Tpeak-Tend interval in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Journal of Electrocardiology. 2011; 42(6):555-560. https://doi.org/10.1016/j.jelectrocard.2009.06.009 PMid:19643432
Ozcan S, Cakmak HA, Ikitimur B. et al. The prognostic significance of narrow fragmented QRS on admission electrocardiogram in patients hospitalized for decompensated systolic heart failure. Clin. Cardiol. 2013; 36(9):560-564. https://doi.org/10.1002/clc.22158 PMid:23754185
Sinha SK, Bhagat K, Asif M. et al. Fragmented QRS as a marker of electrical dyssynchrony to predict ınter-ventricular conduction defect by subsequent echocardiographic assessment in symptomatic patients of non-ıschemic dilated cardiomyopathy. Cardiol Res. 2016; 7(4):140-145. https://doi.org/10.14740/cr495w PMid:28197282 PMCid:PMC5295578
Yontar OC, Karaagac K, Tenekecioglu E. et al. Assessment of ventricular repolarization inhomogeneity in patients with mitral valve prolapse: value of T wave peak to end interval. Int J Clin Exp Med. 2014; 7(8):2173-2178. PMid:25232403 PMCid:PMC4161563
Bazett HC. An analysis of the time relation of electrocardiograms. Heart. 1920; 7:353-367.
Schiller NB, Shah PM, Crawford M. et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of echocardiography committee on standards, subcommittee on quantitation of two-dimensional echocardiograms. J Am Soc Echocardiogr. 1989; 2:358-367. https://doi.org/10.1016/S0894-7317(89)80014-8
Nagueh SF, Appleton CP, Gillebert TC. et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J Am Soc Echocardiogr. 2009; 22:107-133. https://doi.org/10.1016/j.echo.2008.11.023 PMid:19187853
Frederick JR, Woo YJ. Thoracoabdominal aortic aneurysm. Ann Cardiothorac Surg. 2012; 1:277–85. PMid:23977509 PMCid:PMC3741772
Raaz U,Zöllner A. M,Schellinger I. N. et al. Segmental Aortic Stiffening Contributes to Experimental Abdominal Aortic Aneurysm Development. Circulation. 2015; 131(20):1783–1795. https://doi.org/10.1161/CIRCULATIONAHA.114.012377 PMid:25904646 PMCid:PMC4439288
Antzelevitch C. M Cells in the Human Heart. Circ Res. 2010; 106(5):815–817. https://doi.org/10.1161/CIRCRESAHA.109.216226 PMid:20299671 PMCid:PMC2859894
Fish JM, Di Diego JM, Nesterenko VV. Et al. Epicardial activation of left ventricular wall prolongs QT interval and transmural dispersion of repolarization: implications for biventricular pacing. Circulation. 2004; 109:2136–42. https://doi.org/10.1161/01.CIR.0000127423.75608.A4 PMid:15078801
Gellert K.S, Rautaharju P, Snyder M.L. et al.Short-term repeatability of electrocardiographic Tpeak-Tend and QT intervals. J Electrocardiol. 2014; 47(3): 356–361. https://doi.org/10.1016/j.jelectrocard.2014.03.002 PMid:24792986 PMCid:PMC4025961
Porthan K, Viitasalo M, Toivonen L, Havulinna AS, Jula A, Tikkanen JT, Väänänen H, Nieminen MS, Huikuri HV, Newton-Cheh C, Salomaa V. Predictive value of electrocardiographic T-wave morphology parameters and T-wave peak to T-wave end interval for sudden cardiac death in the general population. Circulation: Arrhythmia and Electrophysiology. 2013; 6(4):690-6. https://doi.org/10.1161/CIRCEP.113.000356 PMid:23881778
Hevia J. C, Antzelevitch C, Bárzaga F.T. et al. Tpeak-Tend and Tpeak-Tend Dispersion as Risk Factors for Ventricular Tachycardia/ Ventricular Fibrillation in Patients With the Brugada Syndrome. J Am Coll Cardiol. 2006; 47(9):1828–1834. https://doi.org/10.1016/j.jacc.2005.12.049 PMid:16682308 PMCid:PMC1474075
Shimizu M, Ino H, Okeie K, Yamaguchi M, Nagata M, Hayashi K, Itoh H, Iwaki T, Oe K, Konno T, Mabuchi H. Tâ€peak to Tâ€end interval may be a better predictor of highâ€risk patients with hypertrophic cardiomyopathy associated with a cardiac troponin I mutation than QT dispersion. Clinical cardiology. 2002; 25(7):335-9. https://doi.org/10.1002/clc.4950250706 PMid:12109867
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