Tp-e interval and Tp-e/QTc ratio as novel surrogate markers for prediction of ventricular arrhythmic events in hypertrophic cardiomyopathy

OBJECTIVE: Hypertrophic cardiomyopathy (HCM) as a common genetic heart disease characterized by ventricular hypertrophy and myocardial fibrosis is significantly associated with a higher risk of fatal ventricular arrhythmic events (VAEs). We aimed to assess the interval between the peak and the end of the electrocardiographic T wave (Tp–e) and Tp–e/corrected QT (QTc) ratio as candidate markers of ventricular arrhythmias in patients with HCM. METHODS: In this single-center, prospective study, a total of 66 patients with HCM and 88 controls were enrolled. The patients were divided into two groups: those with VAEs (n=26) and those without VAEs (n=40). Tp–e interval and Tp–e/QTc ratio were measured using a 12-lead electrocardiogram. RESULTS: Tp–e interval was significantly longer and Tp–e/QTc ratio were significantly higher in HCM patients than in the controls. In correlation analysis, maximal left ventricular (LV) thickness also has a significant positive correlation with Tp–e interval (r=0.422, p<0.001) and Tp–e/QTc ratio (r=0.348, p<0.001). Finally, multivariable regression analysis showed that a history of syncope, Tp–e interval [OR (odds ratio): 1.060; 95% confidence interval (CI): 1.005–1.117); p=0.012], Tp–e/QTc ratio (OR:1.148; 95%CI:1.086–1.204); p=0.049], and maximal LV thickness were independent predictors of VAEs in patients with HCM. CONCLUSION: Our findings suggested that prolonged Tp–e interval and increased Tp–e/QTc ratio may be good surrogate markers for the prediction of VAEs in HCM.