Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Xenogiannis Iosif
Dissertation committee:
Δημήτριος Αλεξόπουλος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Ευστάθιος Ηλιοδρομίτης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Γκατζούλης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεράσιμος Φιλιππάτος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Λουκιανός Ραλλίδης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ιωάννης Παρίσης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ιγνάτιος Οικονομίδης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Μεταβολές των αναίμακτων δεικτών διαστρωμάτωσης κινδύνου για αιφνίδιο θάνατο σε ασθενείς με έμφραγμα του μυοκαρδίου και διατηρημένο κλάσμα εξώθησης
Translated title:
Temporal changes of non-invasive risk factors for sudden death in patients with myocardial infarction and preserved ejection fraction
Summary:
Background: Several noninvasive risk factors (NIRFs) have been proposed for sudden cardiac death risk stratification in post-myocardial infarction (post-MI) patients with preserved left ventricular ejection fraction (LVEF). However, it remains unclear if these factors change over time. We aimed to examine the presence of NIRFs temporal changes in the previously mentioned group of patients.Methods: We evaluated seven electrocardiographic NIRFs as they were described in the PRESERVE EF trial in 80 post-MI patients with LVEF ≥ 40%, at least 40 days after revascularization and one year later.Results: Mean patient age was 56 ± 10 years and 88% were men. Mean LVEF was 50 ± 5%. The prevalence of 1) positive late potentials (28% vs 29%, p=0.860), 2) >30 premature ventricular complexes/hour (9% vs 11%, p=0.598), 3) non-sustained ventricular tachycardia (9% vs 5%, p=0.349), 4) standard deviation of the normal-to-normal R-R intervals < 75 msec (4% vs 3%, p=1.000), 5) QTc derived from 24-hour electrocardiography > 440 msec (men) or > 450 msec (women) (18% vs 18%, p=1.000), 6) deceleration capacity ≤ 4.5 msec and heart rate turbulence onset ≥ 0% and slope ≤ 2.5 msec (3% vs 4%. p=1.000) and 7) ambulatory T-wave alternans ≥ 65μV in two Holter channels (6% vs 8%, p=0.755) were similar between the two measurements. However, 5 patients (6.3%) without any NIRFs during the first assessment had at least one positive NIRF at the second assessment and 6 patients (7.5%) with at least one NIRF at baseline had no positive NIRFs at one year.Conclusion: While the prevalence of the examined electrocardiographic NIRFs in post-MI patients with preserved LVEF between the two examinations was similar on a population basis, some patients without NIRFs at baseline developed NIRFs at one year and vice versa, highlighting the need for risk factor reassessment during follow-up.
Main subject category:
Health Sciences
Keywords:
Sudden cardiac death, Post-myocardial infarction, Preserved ejection fraction
Number of references:
254
