Key result
In patients with advanced heart failure, the Tpeak-Tend (Te) interval mean was significantly associated with hospital mortality (OR 1.03; 95% CI 1.01-1.06; p=0.01).
Observational (n=65)
Odds Ratio: 1.03 (95% CI 1.01–1.06)
p-value: p=0.01
Noninvasive hemodynamic and ECG-derived parameters, particularly Tpeak-Tend mean, may help differentiate heart failure phenotypes and predict hospital mortality and treatment response in severe heart failure.
May support noninvasive monitoring in NYHA IV HF; leaves open validation before any clinical adoption.
Using bio-impedance to deduce some hemodynamic parameters combined with some short-term ECG temporal dispersion intervals, and measuring myocardial depolarization, intraventricular conduction, and repolarization. A total of 65 in-hospital patients (M/F:35/30) were enrolled, 39 with HFrEF and 26 HFpEF, in New York Heart Association (NYHA) class IV. Stroke volume (SVI), cardiac indexes (CI), left ventricular ejection fraction (LVEFBIO), end diastolic volume (LV-EDV), and other systolic and diastolic parameters were noninvasively obtained at enrollment and at hospital discharge. At the same time, QR, QRS, QT, ST, Tpeak-Tend (Te) interval mean, and standard deviation (SD) from 5 min ECG recordings were obtained. At baseline, HFrEF patients reported significantly lower SVI (p < 0.05), CI (p < 0.05), and LVEF (p < 0.001) than HFpEF patients; moreover, HFrEF patients also showed increased LV-EDV (p < 0.05), QR, QRS, QT, ST, and Te means (p < 0.05) and standard deviations (p < 0.05) in comparison to HFpEF subjects. Multivariable logistic regression analysis reported a significant correlation between hospital mortality and Te mean (odds ratio: 1.03, 95% confidence limit: 1.01−1.06, p: 0.01). Fifty-seven percent of patients were considered responders to optimal medical therapy and, at discharge, they had significantly reduced NT-proBNP, (p < 0.001), heart rate (p < 0.05), and TeSD (p < 0.001). LVEF, obtained by transthoracic echocardiography, and LVEFBIO were significantly related (r: 0.781, p < 0.001), but these two parameters showed a low agreement limit. Noninvasive hemodynamic and ECG-derived parameters were useful to highlight the difference between HFrEF and HFpEF and between responders and nonresponders to the optimal medical therapy. Short-period bioimpedance and electrocardiographic data should be deeply evaluated to determine possible advantages in the therapeutic and prognostic approach in severe CHF.
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Piccirillo et al. (2022) conducted an observational in Advanced Heart Failure (HFrEF and HFpEF) (n=65). Tpeak-Tend (Te) interval mean was evaluated on Hospital mortality (OR 1.03, 95% CI 1.01-1.06, p=0.01). In patients with advanced heart failure, the Tpeak-Tend (Te) interval mean was significantly associated with hospital mortality (OR 1.03; 95% CI 1.01-1.06; p=0.01).
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