Key result
T-wave alternans amplitude (mean 26 µV) in nonpathological preterm infants significantly correlated with birth weight (ρ=-0.72, p=0.02) and heart-rate variability (ρ=-0.71, p=0.02).
Why the study?
Sudden infant death syndrome is more common in preterm infants and may involve cardiac repolarization instability manifesting as T-wave alternans, prompting analysis of T-wave alternans and its physiological interpretation in nonpathological preterm infants.
Observational
Effect estimate: ρ = -0.72
p-value: p=0.02
Nonpathological preterm infants exhibit measurable T-wave alternans that correlates inversely with birth weight and heart-rate variability, suggesting a potential marker of cardiac repolarization instability related to developmental status.
TWA amplitude was associated with lower birth weight in preterm infants; leaves open its value as a repolarization marker pending prospective studies.
BACKGROUND: Sudden infant death syndrome is more frequent in preterm infants (PTI) than term infants and may be due to cardiac repolarization instability, which may manifest as T-wave alternans (TWA) on the electrocardiogram (ECG). Therefore, the aim of the present work was to analyze TWA in nonpathological PTI and to open an issue on its physiological interpretation. METHODS: weeks; birth weight ranging from 0.84 to 2.10 kg) from whom ECG recordings were obtained ("Preterm infant cardio-respiratory signals database" by Physionet). TWA was identified through the heart-rate adapting match filter method and characterized in terms of mean amplitude values (TWAA). TWA correlation with several other clinical and ECG features, among which gestational age-birth weight ratio, RR interval, heart-rate variability, and QT interval, was also performed. RESULTS: TWA was variable among infants (TWAA = 26 ± 11 µV). Significant correlations were found between TWAA versus birth weight (ρ = -0.72, p = .02), TWAA versus gestational age-birth weight ratio (ρ = 0.76, p = .02) and TWAA versus heart-rate variability (ρ = -0.71, p = .02). CONCLUSIONS: Our preliminary retrospective study suggests that nonpathological PTI show TWA of few tens of µV, the interpretation of which is still an open issue but could indicate a condition of cardiac risk possibly related to the low development status of the infant. Further investigations are needed to solve this issue.
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Marcantoni et al. (2020) conducted an observational in Nonpathological preterm infants. T-wave alternans was evaluated on Correlation of TWA amplitude with birth weight, gestational age-birth weight ratio, and heart-rate variability (ρ = -0.72, p=0.02). T-wave alternans amplitude (mean 26 µV) in nonpathological preterm infants significantly correlated with birth weight (ρ=-0.72, p=0.02) and heart-rate variability (ρ=-0.71, p=0.02).
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