T-Wave Amplitude Variability and the Risk of Death in Chagas Disease
- 14 January 2011
- journal article
- research article
- Published by Wiley in Journal of Cardiovascular Electrophysiology
- Vol. 22 (7), 799-805
- https://doi.org/10.1111/j.1540-8167.2010.02000.x
Abstract
T‐Wave Amplitude Variability in Chagas Disease. Introduction: Measurement of beat‐to‐beat T‐wave amplitude variability (TWV) has been described as a promising new technique for the stratification of arrhythmic risk in postmyocardial infarction and dilated cardiomyopathy patients. Chagas disease (ChD) can lead to a potentially lethal cardiopathy that can present with ventricular arrhythmias, heart blocks, heart failure, and sudden death. The aim of the study was to evaluate the prognostic value of TWV in ChD patients in addition to traditional prognostic predictors. Methods and Results: The study enrolled 113 ambulatory ChD patients (62 men; age: 42 ± 9 years) in sinus rhythm and without other systemic diseases, evaluated by a standard clinical protocol. We computed TWV in 10‐minute ECG recordings obtained in controlled resting conditions. TWV was defined as the median values among 8 consecutive 50‐ms T‐wave segments and dichotomized as either ≤ or > 30 μV2. The association of TWV and death was evaluated by Cox proportional‐hazards analysis, considering other established predictors. During mean follow‐up time of 106 ± 28 months, 14 patients died. A value of median TWV > 30 μV2 predicts increased risk of death in a multivariate analysis (HR = 5.76, 95% CI 1.31–25.23, P = 0.014), in addition to depressed left ventricular function, presence of nonsustained ventricular tachycardia and QRS duration >133 ms. Conclusion: Repolarization variability, evaluated by TWV, is independently related to the risk of death in ChD. This noninvasive methodology could facilitate the identification of patients who may benefit from more aggressive therapeutic strategies. (J Cardiovasc Electrophysiol, Vol. 22, pp. 799‐805, July 2011)Keywords
This publication has 34 references indexed in Scilit:
- Usefulness of T‐Wave Alternans in Sudden Death Risk Stratification and Guiding Medical TherapyAnnals of Noninvasive Electrocardiology, 2010
- T-Wave Variability as a Risk Stratifier in Patients with Dilated CardiomyopathyPacing and Clinical Electrophysiology, 2009
- Sudden cardiac death in Chagas' heart disease in the contemporary eraInternational Journal of Cardiology, 2008
- Repolarization variability in the risk stratification of MADIT II patientsEP Europace, 2007
- A Risk Score for Predicting Death in Chagas' Heart DiseaseNew England Journal of Medicine, 2006
- Abnormalities in Fractal Heart Rate Dynamics in Chagas DiseaseAnnals of Noninvasive Electrocardiology, 2006
- Vagal dysfunction in Chagas diseaseInternational Journal of Cardiology, 2005
- T-wave axis deviation as an independent predictor of mortality in chronic Chagas' diseaseThe American Journal of Cardiology, 2004
- Power-law behavior of heart rate variability in Chagas’ diseaseThe American Journal of Cardiology, 2002
- The ISHNE Holter Standard Output File FormatAnnals of Noninvasive Electrocardiology, 1998