Advanced and traditional electrocardiographic risk factors in pulmonary arterial hypertension: the significance of ventricular late potentials

Uznańska‐Loch, Barbara; Wikło, Kamil; Trzos, Ewa; Wierzbowska−Drabik, Karina; Chrzanowski, Łukasz; Kasprzak, Jarosław D.

doi:10.5603/kp.a2017.0257

Cited by 6 publications

(4 citation statements)

References 24 publications

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“…After these exclusions, 31 studies remained in the present systematic review. Of these studies, three did not report the adjusted HR data (Ho et al, 1997; Kiyono, Hayano, Watanabe, Struzik, & Yamamoto, 2008; Uznańska-Loch et al, 2018); therefore, we finally included 28 eligible studies in the meta-analysis (Ablonskyte-Dudoniene et al, 2012; Al-Zaiti et al, 2014; Anastasiou-Nana et al, 2005; Aronson, Mittleman, & Burger, 2004; Batchvarov et al, 2004; Bonaduce et al, 1999; Bošković et al, 2014; Carpeggiani et al, 2005; Cebula et al, 2012; Cygankiewicz et al, 2015; Erdogan et al, 2008; Gang et al, 2011; Guzzetti et al, 2005; Harris et al, 2014; Hayano et al, 2001; Janszky et al, 2004; Kiviniemi et al, 2007; Krüger et al, 2002; La Rovere et al, 2003; Lanza et al, 1998; Y. Liu et al, 2014; P.…”

Section: Resultsmentioning

confidence: 99%

Heart Rate Variability and Risk of All-Cause Death and Cardiovascular Events in Patients With Cardiovascular Disease: A Meta-Analysis of Cohort Studies

Fang

Tsai

2019

Biological Research For Nursing

181

102

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Lower heart rate variability (HRV) is associated with a higher risk of cardiovascular events and mortality, although the extent of the association is uncertain. We performed a meta-analysis of cohort studies to elucidate the association between HRV and the risk of all-cause death or cardiovascular events in patients with cardiovascular disease (CVD) during a follow-up of at least 1 year. We searched four databases (PubMed, MEDLINE, Embase, and Cochrane Central Register of Controlled Trials) and extracted the adjusted hazard ratio (HR) from eligible studies. We included 28 cohort studies involving 3,094 participants in the meta-analysis. Results revealed that lower HRV was associated with a higher risk of all-cause death and cardiovascular events; the pooled HRs were 2.12 (95% confidence interval [CI] = [1.64, 2.75]) and 1.46 (95% CI [1.19, 1.77]), respectively. In subgroup analyses, the pooled HR of all-cause death was significant for patients with acute myocardial infarction (AMI) but not for those with heart failure. The pooled HR for cardiovascular events was significant for the subgroup of patients with AMI and acute coronary syndrome but not for those with coronary artery disease and heart failure. Additionally, both time and frequency domains of HRV were significantly associated with risk of all-cause death and cardiovascular events in patients with CVD.

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Section: Resultsmentioning

confidence: 99%

Heart Rate Variability and Risk of All-Cause Death and Cardiovascular Events in Patients With Cardiovascular Disease: A Meta-Analysis of Cohort Studies

Fang

Tsai

2019

Biological Research For Nursing

181

102

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“…These findings are in contrast to most other studies with an incidence of nsVT between 5.9% and 13% ( 13 , 32 ). Likewise, in other studies patients with nsVT mainly had group 2 PH (group 1 vs. 2, 15% vs. 48%) ( 34 ). A slightly higher prevalence than the aforementioned studies (but still clearly lower than in our study) was found recently with 16.7% of patients having nsVT in a cohort of patients with PH of all groups (group 1, 2.5%; group 3, 3.1%; group 4, 1.8%; group 5, 0%) ( 35 ).…”

Section: Discussionmentioning

confidence: 52%

Incidence and prognostic significance of malignant arrhythmias during (repetitive) Holter electrocardiograms in patients with pulmonary hypertension

Bandorski

Heibel

Höltgen³

et al. 2023

Front. Cardiovasc. Med.

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BackgroundIn patients with pulmonary hypertension (PH), increased pulmonary vascular resistance (PVR) may lead to increased right ventricular afterload and cardiac remodelling, potentially providing the substrate for ventricular arrhythmias. Studies dealing with long term monitoring of patients with PH are rare. The present study evaluated the incidence and the types of arrhythmias retrospectively recorded by Holter ECG in patients with newly detected PH during a long-term Holter ECG follow-up. Moreover, their impact on patient survival was evaluated.Patients and methodsMedical records were screened for demographic data, aetiology of PH, incidence of coronary heart disease, level of brain natriuretic peptide (BNP), results from Holter ECG monitoring, 6-minute walk test distance, echocardiographic data and hemodynamic data derived from right heart catheterization. Two subgroups were analyzed: 1. patients (n = 65) with PH (group 1 + 4) and derivation of at least 1 Holter ECG within 12 months from initial detection of PH and 2. patients (all PH etiologies, n = 59) with 3 follow-up Holter ECGs. The frequency and complexity of premature ventricular contractions (PVC) was classified into “lower” and “higher” (=non sustained ventricular tachycardia, nsVT) burden.ResultsHolter ECG revealed sinus rhythm (SR) in most of the patients (n = 60). Incidence of atrial fibrillation (AFib) was low (n = 4). Patients with premature atrial contractions (PAC) tend to have a shorter period of survival (p = 0.098), PVC were not correlated with significant survival differences. During follow-up PAC and PVC were common in all PH groups. Holter ECG revealed non sustained ventricular tachycardia in 19/59 patients [(32.2%); n = 6 during first Holter-ECG, n = 13 during second/third Holter-ECG]. In all patients suffering from nsVT during follow-up previous Holter ECG revealed multiform/repetitive PVC. PVC burden was not linked to differences in systolic pulmonary arterial pressure, right atrial pressure, brain natriuretic peptide and results of six-minute walk test.ConclusionPatients with PAC tend to have a shortened survival. None of the evaluated parameters (BNP, TAPSE, sPAP) was correlated with the development of arrhythmias. Patients with multiform/repetitive PVC seem to be at risk for ventricular arrhythmias.

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“…Several methods for the inclusion of HRT in implantable cardioverter defibrillators have already been suggested ( 10 – 12 ). Similarly, GE Healthcare implemented HRT assessment in their Holter analysis software tools MARS and CardioDay , which both have already been used for HRT analysis ( 13 – 15 ).…”

Section: Introductionmentioning

confidence: 99%

Comparability of Heart Rate Turbulence Methodology: 15 Intervals Suffice to Calculate Turbulence Slope – A Methodological Analysis Using PhysioNet Data of 1074 Patients

Blesius

Schölzel

Ernst

et al. 2022

Front. Cardiovasc. Med.

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Heart rate turbulence (HRT) is a characteristic heart rate pattern triggered by a ventricular premature contraction (VPC). It can be used to assess autonomic function and health risk for various conditions, e.g., coronary artery disease or cardiomyopathy. While comparability is essential for scientific analysis, especially for research focusing on clinical application, the methodology of HRT still varies widely in the literature. Particularly, the ECG measurement and parameter calculation of HRT differs, including the calculation of turbulence slope (TS). In this article, we focus on common variations in the number of intervals after the VPC that are used to calculate TS (#TSRR) posing two questions: 1) Does a change in #TSRR introduce noticeable changes in HRT parameter values and classification? and 2) Do larger values of turbulence timing (TT) enabled by a larger #TSRR still represent distinct HRT? We compiled a free-access data set of 1,080 annotated long-term ECGs provided by Physionet. HRT parameter values and risk classes were determined both with #TSRR 15 and 20. A standard local tachogram was created by averaging the tachograms of only the files with the best heart rate variability values. The shape of this standard VPC sequence was compared to all VPC sequences grouped by their TT value using dynamic time warping (DTW) in order to identify HRT shapes. When calculated with different #TSRR, our results show only a little difference between the number of files with enough valid VPC sequences to calculate HRT (<1%) and files with different risk classes (5 and 6% for HRT0-2 and HRTA-C, respectively). In the DTW analysis, the difference between averaged sequences with a specific TT and the standard sequence increased with increasing TT. Our analysis suggests that HRT occurs in the early intervals after the VPC and TS calculated from late intervals reflects common heart rate variability rather than a distinct response to the VPC. Even though the differences in classification are marginal, this can lead to problems in clinical application and scientific research. Therefore, we recommend uniformly using #TSRR 15 in HRT analysis.

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Advanced and traditional electrocardiographic risk factors in pulmonary arterial hypertension: the significance of ventricular late potentials

Abstract: Ventricular LP were present in 19% of PAH patients and were the most powerful risk factor of mortality .

Cited by 6 publications

References 24 publications

Heart Rate Variability and Risk of All-Cause Death and Cardiovascular Events in Patients With Cardiovascular Disease: A Meta-Analysis of Cohort Studies

Heart Rate Variability and Risk of All-Cause Death and Cardiovascular Events in Patients With Cardiovascular Disease: A Meta-Analysis of Cohort Studies

Incidence and prognostic significance of malignant arrhythmias during (repetitive) Holter electrocardiograms in patients with pulmonary hypertension

Comparability of Heart Rate Turbulence Methodology: 15 Intervals Suffice to Calculate Turbulence Slope – A Methodological Analysis Using PhysioNet Data of 1074 Patients

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