Electrocardiographic Predictors of Sudden Cardiac Death in Patients with Left Ventricular Hypertrophy

Annals of noninvasive electrocardiology: the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc

article

Ragesh Panikkath¹  Kyndaron Reinier¹  Audrey Uy-Evanado¹  Carmen Teodorescu¹  Karen Gunson²  Jonathan Jui³  Sumeet S. Chugh¹ 

[1] Heart Institute, Cedars-Sinai Medical Center;Department of Pathology, Oregon Health and Science University;Department of Emergency Medicine, Oregon Health and Science University

关键词: sudden cardiac death;    left ventricular hypertrophy;    QT interval;    risk prediction;   

DOI  :  10.1111/anec.12003

来源: Wiley

【 摘 要 】

Background Left ventricular hypertrophy (LVH) has been associated with increased risk of sudden cardiac death (SCD), and improvements in risk stratification methodology are warranted. Methods We evaluated electrocardiographic intervals as potential markers of SCD risk in LVH. Corrected QT, QRS, and JT intervals were evaluated in consecutive cases with SCD and LVH from the ongoing Oregon Sudden Unexpected Death study who underwent a 12-lead electrocardiogram (EKG) and echocardiogram prior to and unrelated to the SCD event. Comparisons of age, gender, body mass index, LV ejection fraction, and EKG intervals together with clinical conditions (hypertension and diabetes) were conducted with geographically matched controls that had coronary artery disease but no history of ventricular arrhythmias or cardiac arrest. LVH was determined using the modified American Society of Echocardiography equation for LV mass. Independent samples t -test, Pearson's chi-square test, and multiple logistic regression were used for statistical comparisons. Results Of the 109 cases and 49 controls who met study criteria, age, gender, and comorbidities were similar among cases and controls. The mean LV mass index was not significantly different in cases compared to controls. However mean QTc (470.6 ± 53.6 ms vs 440.7 ± 38.7 ms; P < 0.0001) and QRS duration (113.6 ± 30.0 ms vs 104.9 ± 18.7 ms; P = 0.03) were significantly higher in cases than controls. In logistic regression analysis, prolonged QTc was the only EKG interval significantly associated with SCD (OR 1.72 [1.23–2.40]). Conclusion Prolonged QTc was independently associated with SCD among subjects with LVH and merits further evaluation as a predictor of SCD in LVH.

【 授权许可】

Unknown