TY - JOUR
TI - QT interval extracted from 30-minute short resting Holter ECG recordings predicts mortality in heart failure
AU - Arsenos, P.
AU - Gatzoulis, K.A.
AU - Laina, A.
AU - Doundoulakis, I.
AU - Soulaidopoulos, S.
AU - Kordalis, A.
AU - Oikonomou, G.
AU - Triantafyllou, K.
AU - Fragakis, N.
AU - Vasilikos, V.
AU - Tsioufis, K.
JO - Journal of Electrocardiology
PY - 2022
VL - 72
TODO - null
SP - 109-114
PB - Elsevier B.V.
SN - 0022-0736, 1532-8430
TODO - 10.1016/j.jelectrocard.2022.03.013
TODO - adult;  aged;  Article;  cardiovascular mortality;  cardiovascular parameters;  controlled study;  female;  heart failure;  heart left ventricle ejection fraction;  heart rate;  heart rate variability;  Holter monitoring;  human;  independent variable;  major clinical study;  male;  middle aged;  prediction;  predictor variable;  prospective study;  QRS interval;  QT interval;  standard deviation of normal to normal;  survival;  ambulatory electrocardiography;  electrocardiography;  long QT syndrome;  physiology;  procedures;  rest, Aged;  Electrocardiography;  Electrocardiography, Ambulatory;  Heart Failure;  Heart Rate;  Humans;  Long QT Syndrome;  Male;  Middle Aged;  Rest
TODO - Background: Prolonged repolarization duration is a significant total mortality (TM) predictor in post-myocardial infarction patients. Aim: We examined the clinical significance of QT interval that was extracted from a Short Resting Holter ECG (SRH ECG – 30-min duration) as a TM predictor in heart failure (HF) patients. Methods: One hundred forty-five HF patients (male = 84%, mean age = 64 ± 12 years, mean LVEF = 33 ± 10%) underwent an SRH ECG recording for 30 min. These high-resolution ECG signals were analyzed and the QT interval was calculated and corrected according to the Fridericia formula. After 42.1 months, 26 patients died. Results: Univariate analysis for Deceased and Living groups: QTc:455 ± 33 ms vs 441 ± 32 ms (p = 0.04), LVEF:32 ± 10% vs 34 ± 9% (p < 0.5), Mean Heart Rate: 73 ± 11 bpm vs 69 ± 12 bpm (p = 0.2), SDNN/HRV: 45 ± 42 ms vs 41 ± 29 ms (p = 0.4), QRS: 123 ± 26 ms vs 119 ± 29 ms (p = 0.5). Multivariate Cox regression analysis with model adjusted for QTc, Mean Heart Rate, LVEF, QRS, revealed that QTc-Fridericia interval was an independent TM predictor (H.R.:1.017, 95% C.I.: 1.003–1.030, p = 0.01). The cut-off point of 490 ms (90th percentile) in the same model presented HR: 2.9 for TM (95%C.I.: 1.066–7.882, p = 0.03). Kaplan Meier curves depicted a clear difference in survival between the two patients' groups (QTc Group≥490 ms vs QTc Group <490 ms). The curve diverge was important (log-rank, p = 0.02). Conclusion: A fast risk stratification approach with SRH ECG recording is an efficient method for flash evaluation of mortality risk in HF patients. © 2022 Elsevier Inc.
ER -