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Titolo:
Analysis of 12-lead T-wave morphology for risk stratification after myocardial infarction
Autore:
Zabel, M; Acar, B; Klingenheben, T; Franz, MR; Hohnloser, SH; Malik, M;
Indirizzi:
St George Hosp, Sch Med, London SW17 0RE, England St George Hosp London England SW17 0RE Sch Med, London SW17 0RE, England Free Univ Berlin, Klinikum Benjamin Franklin, Div Cardiol, D-12200 Berlin,Germany Free Univ Berlin Berlin Germany D-12200 Cardiol, D-12200 Berlin,Germany Univ Frankfurt, Div Cardiol, D-6000 Frankfurt, Germany Univ Frankfurt Frankfurt Germany D-6000 rdiol, D-6000 Frankfurt, Germany VA Med Ctr, Div Cardiol, Washington, DC USA VA Med Ctr Washington DC USAVA Med Ctr, Div Cardiol, Washington, DC USA
Titolo Testata:
CIRCULATION
fascicolo: 11, volume: 102, anno: 2000,
pagine: 1252 - 1257
SICI:
0009-7322(20000912)102:11<1252:AO1TMF>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
QT INTERVAL DISPERSION; TORSADE-DE-POINTES; VENTRICULAR REPOLARIZATION; TACHYCARDIA; MORTALITY; HEART; REPRODUCIBILITY; VULNERABILITY; ARRHYTHMIAS; MECHANISM;
Keywords:
myocardial infarction; death, sudden; risk factors; waves; electrocardiography;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
37
Recensione:
Indirizzi per estratti:
Indirizzo: Malik, M St George Hosp, Sch Med, London SW17 0RE, England St George HospLondon England SW17 0RE London SW17 0RE, England
Citazione:
M. Zabel et al., "Analysis of 12-lead T-wave morphology for risk stratification after myocardial infarction", CIRCULATION, 102(11), 2000, pp. 1252-1257

Abstract

Background-The stratification of post-myocardial infarction (MI) patients at risk of sudden cardiac death remains important. The aim of the present study was to assess the prognostic value of novel T-wave morphology descriptors derived from resting 12-lead ECGs. Methods and Results-In 280 consecutive post-MI patients, a 12-lead ECG wasrecorded before discharge, optically scanned, and digitized. For the present study, 5 T-wave morphology descriptors were automatically calculated after singular value decomposition of the ECG signal. The total cosine R-to-T (TCRT [describes the global angle between repolarization and depolarizationwavefront]) and the T-wave loop dispersion were univariately associated (P= 0.0002 and P < 0.002, respectively, U test) with 27 prospectively defined clinical events in 261 patients (mean follow-up 32 +/- 10 months). Kaplan-Meier event probability curves for strata above and below the median confirmed the strong risk discrimination by TCRT and T-wave loop dispersion (P <0.003 and P < 0.001, respectively, log-rank test). On Cox regression analysis, with the entering of age, left ventricular ejection fraction, heart rate, QRS width, reperfusion therapy, beta-adrenergic-blocker treatment, and standard deviation of R-R intervals on 24-hour Holter monitoring, TCRT (P <0.03) yielded independent predictive value, whereas T-wave loop dispersionwas of borderline independence (P = 0.064). Heart rate (P < 0.02), left ventricular ejection fraction (P < 0.02), and reperfusion therapy (P < 0.02) also remained in the final model. Conclusions-Computerized T-wave morphology analysis of the 12-lead restingECG permits independent assessment of post-MI risk and an improved risk stratification when combined with other risk markers.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/09/20 alle ore 04:59:34