Key result
In patients with heart failure, traditional indices of transmural dispersion of repolarization such as Tp-Te interval and Tp-Te/QT ratio did not differ significantly across preserved, mid-range, and reduced ejection fraction groups, though newer indices like S-Te and S-Tp showed significant differences.
Why the study?
Tp-Te interval reflects transmural dispersion of repolarisation and predicts ventricular arrhythmia risk, but assessment of these repolarisation indices across HFpEF, HFmrEF, and HFrEF classes was needed.
Cross-Sectional (n=192)
Single-blind
No
Answers are grounded in this paper and cite their sources.
Traditional ECG indices of transmural dispersion of repolarization like Tp-Te do not differ significantly across heart failure ejection fraction categories, though other intervals like QTp and S-Te show differences.
BACKGROUND: Heart failure (HF) is classified in three class: HF with preserved EF (HFpEF); normal or LVEF ≥ 50%, HF with reduced EF (HFrEF); LEVF < 40% and newly HF mid-range EF (HFmrEF); LVEF 40-49%. On Electrocardiography (ECG) T wave, Tpeak-Tend (Tp-Te) interval reflects transmural dispersion of repolarisation (TDR) which of these indexes have been proposed as predictors of risk for ventricular arrhythmia (VA) in many cardiac diseases. AIM: Aim of this study to asses these indices of TDR among three HF class. METHODS: Total of 192 patients were included in this study. RESULTS: Many of indices like Tp-Te, Tp-Te/QT wasn't different between groups (P > 0.05). But mean Q-Tpeak (QTp), S-Tend (S-Te) and S-Tpeak (S-Tp) were found significantly different between groups (P < 0.05). Again S-Te was found different according to having fragmented QRS (fQRS) on ECG (P = 0.031). Comparing to mitral inflow E/A parameters showed significant differences for Tp-Te, Tp-Tec, Tp-Te/QT, Tp-Te/QTc and Tp-Tec/QTc parameters. Finally, we found correlations between S-Te and white blood cell (WBC) (r = - 0.171; P = 0.037) and S-Tp and WBC (r = - 0.170; P = 0.038) and between S-Te and fQRS (r = 0.158; P = 0.031). CONCLUSIONS: We didn't find differences for many of indices of TDR like Tp-Te interval between groups except QTp, S-Te, S-Tp intervals. Also, S-Te and fQRS showed significant correlation. For prediction of ventricular arrhythmia and cardiovascular death newer indexes on ECG are needed to be established in the future which will make us facilitate to distinguish high risk patients.
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Son et al. (2019) conducted a cross-sectional in Heart Failure (n=192). Heart failure ejection fraction category (HFrEF, HFmrEF, HFpEF) vs. Comparison among the three LVEF groups was evaluated on Tp-Te interval (p=0.291). In patients with heart failure, traditional indices of transmural dispersion of repolarization such as Tp-Te interval and Tp-Te/QT ratio did not differ significantly across preserved, mid-range, and reduced ejection fraction groups, though newer indices like S-Te and S-Tp showed significant differences.
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