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Predictive Value of T(peak) – T(end) Indices for Adverse Outcomes in Acquired QT Prolongation: A Meta-Analysis

Background: Acquired QT interval prolongation has been linked with malignant ventricular arrhythmias, such as torsade de pointes, in turn predisposing to sudden cardiac death. Increased dispersion of repolarization has been identified as a pro-arrhythmic factor and can be observed as longer T(peak)...

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Autores principales: Tse, Gary, Gong, Mengqi, Meng, Lei, Wong, Cheuk W., Bazoukis, George, Chan, Matthew T. V., Wong, Martin C. S., Letsas, Konstantinos P., Baranchuk, Adrian, Yan, Gan-Xin, Liu, Tong, Wu, William K. K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6129769/
https://www.ncbi.nlm.nih.gov/pubmed/30233403
http://dx.doi.org/10.3389/fphys.2018.01226
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author Tse, Gary
Gong, Mengqi
Meng, Lei
Wong, Cheuk W.
Bazoukis, George
Chan, Matthew T. V.
Wong, Martin C. S.
Letsas, Konstantinos P.
Baranchuk, Adrian
Yan, Gan-Xin
Liu, Tong
Wu, William K. K.
author_facet Tse, Gary
Gong, Mengqi
Meng, Lei
Wong, Cheuk W.
Bazoukis, George
Chan, Matthew T. V.
Wong, Martin C. S.
Letsas, Konstantinos P.
Baranchuk, Adrian
Yan, Gan-Xin
Liu, Tong
Wu, William K. K.
author_sort Tse, Gary
collection PubMed
description Background: Acquired QT interval prolongation has been linked with malignant ventricular arrhythmias, such as torsade de pointes, in turn predisposing to sudden cardiac death. Increased dispersion of repolarization has been identified as a pro-arrhythmic factor and can be observed as longer T(peak) – T(end) interval and higher T(peak) – T(end)/QT ratio on the electrocardiogram. However, the values of these repolarization indices for predicting adverse outcomes in this context have not been systematically evaluated. Method: PubMed, Embase and Cochrane Library databases were searched until 14th February 2018, identifying 232 studies. Results: Five studies on acquired QT prolongation met the inclusion criteria and 308 subjects with drug-induced LQTS patients (mean age: 66 ± 18 years old; 46% male) were included in this meta-analysis. T(peak) – T(end) intervals were longer [mean difference [MD]: 76 ms, standard error [SE]: 26 ms, P = 0.003; I(2) = 98%] and T(peak) – T(end)/QT ratios were higher (MD: 0.14, SE: 0.03, P = 0.000; I(2) = 29%) in patients with torsade de pointes compared to those without these events. Conclusion: T(peak) – T(end) interval and T(peak) – T(end)/QT ratio were higher in patients with acquired QT prolongation suffering from torsade de pointes compared to those who did not. These repolarization indices may provide additional predictive value for identifying high-risk individuals.
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spelling pubmed-61297692018-09-19 Predictive Value of T(peak) – T(end) Indices for Adverse Outcomes in Acquired QT Prolongation: A Meta-Analysis Tse, Gary Gong, Mengqi Meng, Lei Wong, Cheuk W. Bazoukis, George Chan, Matthew T. V. Wong, Martin C. S. Letsas, Konstantinos P. Baranchuk, Adrian Yan, Gan-Xin Liu, Tong Wu, William K. K. Front Physiol Physiology Background: Acquired QT interval prolongation has been linked with malignant ventricular arrhythmias, such as torsade de pointes, in turn predisposing to sudden cardiac death. Increased dispersion of repolarization has been identified as a pro-arrhythmic factor and can be observed as longer T(peak) – T(end) interval and higher T(peak) – T(end)/QT ratio on the electrocardiogram. However, the values of these repolarization indices for predicting adverse outcomes in this context have not been systematically evaluated. Method: PubMed, Embase and Cochrane Library databases were searched until 14th February 2018, identifying 232 studies. Results: Five studies on acquired QT prolongation met the inclusion criteria and 308 subjects with drug-induced LQTS patients (mean age: 66 ± 18 years old; 46% male) were included in this meta-analysis. T(peak) – T(end) intervals were longer [mean difference [MD]: 76 ms, standard error [SE]: 26 ms, P = 0.003; I(2) = 98%] and T(peak) – T(end)/QT ratios were higher (MD: 0.14, SE: 0.03, P = 0.000; I(2) = 29%) in patients with torsade de pointes compared to those without these events. Conclusion: T(peak) – T(end) interval and T(peak) – T(end)/QT ratio were higher in patients with acquired QT prolongation suffering from torsade de pointes compared to those who did not. These repolarization indices may provide additional predictive value for identifying high-risk individuals. Frontiers Media S.A. 2018-09-03 /pmc/articles/PMC6129769/ /pubmed/30233403 http://dx.doi.org/10.3389/fphys.2018.01226 Text en Copyright © 2018 Tse, Gong, Meng, Wong, Bazoukis, Chan, Wong, Letsas, Baranchuk, Yan, Liu and Wu. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Physiology
Tse, Gary
Gong, Mengqi
Meng, Lei
Wong, Cheuk W.
Bazoukis, George
Chan, Matthew T. V.
Wong, Martin C. S.
Letsas, Konstantinos P.
Baranchuk, Adrian
Yan, Gan-Xin
Liu, Tong
Wu, William K. K.
Predictive Value of T(peak) – T(end) Indices for Adverse Outcomes in Acquired QT Prolongation: A Meta-Analysis
title Predictive Value of T(peak) – T(end) Indices for Adverse Outcomes in Acquired QT Prolongation: A Meta-Analysis
title_full Predictive Value of T(peak) – T(end) Indices for Adverse Outcomes in Acquired QT Prolongation: A Meta-Analysis
title_fullStr Predictive Value of T(peak) – T(end) Indices for Adverse Outcomes in Acquired QT Prolongation: A Meta-Analysis
title_full_unstemmed Predictive Value of T(peak) – T(end) Indices for Adverse Outcomes in Acquired QT Prolongation: A Meta-Analysis
title_short Predictive Value of T(peak) – T(end) Indices for Adverse Outcomes in Acquired QT Prolongation: A Meta-Analysis
title_sort predictive value of t(peak) – t(end) indices for adverse outcomes in acquired qt prolongation: a meta-analysis
topic Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6129769/
https://www.ncbi.nlm.nih.gov/pubmed/30233403
http://dx.doi.org/10.3389/fphys.2018.01226
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