Key result
Increased Tpeak-Tend variance and mean predict longer hospital stays and higher 30-day mortality.
Why the study?
Increased repolarization temporal imbalance increases mortality risk, but whether short-period electrocardiographic repolarization markers predict length of hospital stay and mortality in acutely decompensated chronic heart failure is unknown.
Do electrocardiographic short period markers of repolarization temporal dispersion predict hospital stay length and mortality in patients with acutely decompensated chronic heart failure?
Observational (n=139)
Do electrocardiographic short period markers of repolarization temporal dispersion predict hospital stay length and mortality in patients with acutely decompensated chronic heart failure?
Effect estimate: HR 1.04 (hospital stay), HR 1.02 (mortality) (95% CI 1.01-1.08, 1.01-1.03)
p-value: p=< .05
Short-period ECG markers of repolarization temporal dispersion, specifically Tpeak-Tend variability and mean, can serve as noninvasive predictors of hospital length of stay and 30-day mortality in acute decompensated heart failure.
May support ECG risk stratification in acute decompensated HF; hypothesis-generating and requires prospective validation.
BACKGROUND: As previously reported, an increased repolarization temporal imbalance induces a higher risk of total/cardiovascular mortality. HYPOTHESIS: The aim of this study was to assess if the electrocardiographic short period markers of repolarization temporal dispersion could be predictive of the hospital stay length and mortality in patients with acutely decompensated chronic heart failure (CHF). METHOD: Mean, standard deviation (SD), and normalized variance (VN) of QT (QT) and Tpeak-Tend (Te) were obtained on 5-min ECG recording in 139 patients hospitalized for acutely decompensated CHF, subgrouping the patients for hospital length of stay (LoS): less or equal 1 week (≤1 W) and those with more than 1 week (>1 W). RESULTS: We observed an increase of short-period repolarization variables (TeSD and TeVN, p < .05), a decrease of blood pressure (p < .05), lower ejection fraction (p < .05), and higher plasma level of biomarkers (NT-proBNP, p < .001; Troponin, p < .05) in >1 W LoS subjects. 30-day deceased subjects reported significantly higher levels of QTSD (p < .05), Te mean (p < .001), TeSD (p < .05), QTVN (p < .05) in comparison to the survivors. Multivariable Cox regression analysis reported that TeVN was a risk factor for longer hospital stay (hazard ratio: 1.04, 95% confidence limit: 1.01-1.08, p < .05); whereas, a longer Te mean was associated with higher mortality risk (hazard ratio: 1.02, 95% confidence limit: 1.01-1.03, p < .05). CONCLUSION: A longer hospital stay is considered a clinical surrogate of CHF severity, we confirmed this finding. Therefore, these electrical and simple parameters could be used as noninvasive, transmissible, inexpensive markers of CHF severity and mortality.
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Piccirillo et al. (2022) conducted an observational in Acutely decompensated chronic heart failure (n=139). Electrocardiographic short period markers of repolarization temporal dispersion (QT and Tpeak-Tend) was evaluated on Hospital stay length and 30-day mortality (HR 1.04 (hospital stay), HR 1.02 (mortality), 95% CI 1.01-1.08, 1.01-1.03, p=< .05). Increased Tpeak-Tend normalized variance predicted longer hospital stay (HR 1.04; 95% CI 1.01-1.08), and longer Tpeak-Tend mean predicted higher 30-day mortality (HR 1.02; 95% CI 1.01-1.03).
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