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Dykiert I, Florek K, Kraik K, Gać P, Poręba R, Poręba M. Tpeak-Tend ECG Marker in Obesity and Cardiovascular Diseases: A Comprehensive Review. SCIENTIFICA 2024; 2024:4904508. [PMID: 38962529 PMCID: PMC11221957 DOI: 10.1155/2024/4904508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 05/13/2024] [Accepted: 06/13/2024] [Indexed: 07/05/2024]
Abstract
Globally, cardiovascular diseases are still the leading cause of death. Numerous methods are used to diagnose cardiovascular pathologies; there is still a place for straightforward and noninvasive techniques, such as electrocardiogram (ECG). Depolarization and repolarization parameters, including QT interval and its derivatives, are well studied. However, the Tpeak-Tend interval is a novel and promising ECG marker with growing evidence for its potential role in predicting malignant arrhythmias. In this review, we discuss the association between the Tpeak-Tend interval and several cardiovascular diseases, including long QT syndrome, cardiomyopathies, heart failure, myocardial infarction, and obesity, which constitutes one of the risk factors for cardiovascular diseases.
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Affiliation(s)
- Irena Dykiert
- Division of PathophysiologyDepartment of Physiology and PathophysiologyWroclaw Medical University, Wrocław, Poland
| | - Kamila Florek
- Students' Scientific Association of Cardiovascular Diseases PreventionDepartment of Internal and Occupational DiseasesHypertension and Clinical OncologyWroclaw Medical University, Wrocław, Poland
| | - Krzysztof Kraik
- Students' Scientific Association of Cardiovascular Diseases PreventionDepartment of Internal and Occupational DiseasesHypertension and Clinical OncologyWroclaw Medical University, Wrocław, Poland
| | - Paweł Gać
- Division of Environmental Health and Occupational MedicineDepartment of Population HealthWroclaw Medical University, Wrocław, Poland
| | - Rafał Poręba
- Department of Internal and Occupational DiseasesHypertension and Clinical OncologyWroclaw Medical University, Wrocław, Poland
| | - Małgorzata Poręba
- Department of Paralympic SportWroclaw University of Health and Sport Sciences, Wrocław, Poland
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Avci Y, Demir AR, Bulut U, Demirci G, Karakurt ST, Sancar KM, Aktemur T, Uygur B, Ersoy B, Erturk M. Novel markers of ventricular repolarization are associated with mortality in patients undergoing surgical aortic valve replacement for severe aortic stenosis. J Card Surg 2021; 36:4591-4596. [PMID: 34628679 DOI: 10.1111/jocs.16063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Aortic stenosis (AS) is the most common degenerative valvular heart disease that can affect left ventricular functions. Tp-e interval and Tp-e/QT ratio is a novel repolarization marker which is associated with adverse cardiovascular events in several cardiovascular diseases. In our study, our aim is to investigate the prognostic effect of Tp-e interval, Tp-e/QT and Tp-e/QTc ratios on mortality in patients who underwent successful surgical aortic valve replacement (AVR). METHODS A total of three hundred seventy-five patients undergoing successful surgical AVR were included in this study. Then, patients were divided into two groups according to mortality as group 1 without mortality (342 patients) and group 2 with mortality (33 patients). Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were calculated for both groups. RESULTS Tp-e interval (71 (63.7-77); 86 (84-88), p < .001), Tp-e/QT ratio (0.19 (0.17-0.20); 0.23 (0.22-0.23), p < .001) and Tp-e/QTc ratio (0.17 ± 0.02; 0.21 ± 0.01, p < .001) were higher in group 2 compared to group 1. In multivariate logistic regression analyses Tp-e interval (odds ratio [OR]: 1.315, 95% confidence interval [CI]: 1.203-1.437, p < .001), Tp-e/QT ratio (OR: 7.334, 95% CI: 3.274-1.643, p < .001) and Tp-e/QTc ratio (OR: 2.567, 95% CI: 4.106-1.605, p < .001) were found to be independent predictors of mortality. Additionally, a Kaplan-Meier survival analysis also revealed that long term survival was found to be significantly decreased in patients with higher Tp-e/QT ratio (Log-Rank p < .001) and Tp-e/QTc ratio (Log-Rank p < .001). CONCLUSION Tp-e interval, Tp-e dispersion, Tp-e/QT, and Tp-e/QTc ratios are associated with worse prognosis after surgical AVR in patients with severe AS. All of them are also independent predictors of mortality.
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Affiliation(s)
- Yalcin Avci
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ali R Demir
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Umit Bulut
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gökhan Demirci
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Seda T Karakurt
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Kadriye M Sancar
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Tugba Aktemur
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Begüm Uygur
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Burak Ersoy
- Department of Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mehmet Erturk
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Ullah W, Zahid S, Zaidi SR, Sarvepalli D, Haq S, Roomi S, Mukhtar M, Khan MA, Gowda SN, Ruggiero N, Vishnevsky A, Fischman DL. Predictors of Permanent Pacemaker Implantation in Patients Undergoing Transcatheter Aortic Valve Replacement - A Systematic Review and Meta-Analysis. J Am Heart Assoc 2021; 10:e020906. [PMID: 34259045 PMCID: PMC8483489 DOI: 10.1161/jaha.121.020906] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background As transcatheter aortic valve replacement (TAVR) technology expands to healthy and lower‐risk populations, the burden and predictors of procedure‐related complications including the need for permanent pacemaker (PPM) implantation needs to be identified. Methods and Results Digital databases were systematically searched to identify studies reporting the incidence of PPM implantation after TAVR. A random‐ and fixed‐effects model was used to calculate unadjusted odds ratios (OR) for all predictors. A total of 78 studies, recruiting 31 261 patients were included in the final analysis. Overall, 6212 patients required a PPM, with a mean of 18.9% PPM per study and net rate ranging from 0.16% to 51%. The pooled estimates on a random‐effects model indicated significantly higher odds of post‐TAVR PPM implantation for men (OR, 1.16; 95% CI, 1.04–1.28); for patients with baseline mobitz type‐1 second‐degree atrioventricular block (OR, 3.13; 95% CI, 1.64–5.93), left anterior hemiblock (OR, 1.43; 95% CI, 1.09–1.86), bifascicular block (OR, 2.59; 95% CI, 1.52–4.42), right bundle‐branch block (OR, 2.48; 95% CI, 2.17–2.83), and for periprocedural atriorventricular block (OR, 4.17; 95% CI, 2.69–6.46). The mechanically expandable valves had 1.44 (95% CI, 1.18–1.76), while self‐expandable valves had 1.93 (95% CI, 1.42–2.63) fold higher odds of PPM requirement compared with self‐expandable and balloon‐expandable valves, respectively. Conclusions Male sex, baseline atrioventricular conduction delays, intraprocedural atrioventricular block, and use of mechanically expandable and self‐expanding prosthesis served as positive predictors of PPM implantation in patients undergoing TAVR.
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Affiliation(s)
- Waqas Ullah
- Thomas Jefferson University Hospitals Philadelphia PA
| | | | | | | | | | | | - Maryam Mukhtar
- University Hospitals of Leicester NHS Trust Leicester UK
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Karacop E, Enhos A. Predictive role of ventricular repolarization parameters for the occurrence of complete heart block in patients undergoing transcatheter aortic valve implantation. Ann Noninvasive Electrocardiol 2019; 25:e12734. [PMID: 31811688 PMCID: PMC7358893 DOI: 10.1111/anec.12734] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/11/2019] [Accepted: 11/11/2019] [Indexed: 01/28/2023] Open
Abstract
Background We investigated the role of ventricular repolarization parameters to predict complete atrioventricular block in patients undergoing transcatheter aortic valve implantation (TAVI). Methods A total of 150 patients undergoing TAVI due to severe aortic stenosis were included in this retrospective cohort study. Patients were assigned in two groups based on the presence (n: 49) or absence (n: 101) of complete atrioventricular block after TAVI. Ventricular repolarization intervals (QT, QTc, JT, JTc, TP‐E), indices (QT dispersion), and ratios (TP‐E/QT, TP‐E/QTc, TP‐E/JTc) were measured. Results Electrocardiographic repolarization parameters such as Tp‐e interval: 74.2 ± 5.1 versus 59.2 ± 6.1 ms, p < .001; QTc interval: 397.6 ± 3.4 versus 368.1 ± 7.8 ms, p < .001; JTc interval: 317.4 ± 11.3 versus 291.1 ± 6.7 ms, p < .001; Tp‐e/QT ratio: 0.28 ± 0.04 versus 0.20 ± 0.04, p < .001; Tp‐e/QTc ratio: 0.29 ± 0.04 versus 0.19 ± 0.03, p < .001; Tp‐e/JT ratio: 0.32 ± 0.03 versus 0.23 ± 0.03, p < .001; Tp‐e/JTc ratio: 0.30 ± 0.02 versus 0.2 ± 0.03, p < .001; and QT dispersion: 34.4 ± 3.0 versus 17.8 ± 3.6 ms, p < .01 were significantly higher in post‐TAVI permanent pacemaker group. In a univariate regression analysis, pulmonary artery pressure, heart rate, coronary artery disease, Tp‐e/QTc, Tp‐e/JTc, and PR interval were significantly associated with complete heart block. Tp‐e/JTc (OR 0.373, p = .067) and PR interval (OR 0.898, p = .079) were found to be independent predictors of these type of arrhythmias in a multivariate analysis. But it is not statistically significant. Conclusion Our results suggest that repolarization parameters may play a role in predicting complete atrioventricular block. Tp‐e/JTc was found to be potential independent risk marker for this setting.
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Affiliation(s)
- Erdem Karacop
- Department of Cardiology, Faculty of Medicine, BezmiÂlem Foundation University, Istanbul, Turkey
| | - Asim Enhos
- Department of Cardiology, Faculty of Medicine, BezmiÂlem Foundation University, Istanbul, Turkey
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