Prognostic Value of T-Wave Alternans in Patients With Heart Failure Due to Nonischemic Cardiomyopathy

Salerno‐Uriarte, Jorge A.; Ferrari, Gaetano M. De; Klersy, Catherine; Pedretti, Roberto F.E.; Tritto, Massimo; Sallusti, Luciano; Libero, L; Pettinati, G.; Molon, Giulio; Curnis, Antonio; Occhetta, Eraldo; Morandi, Fabrizio; Ferrero, Paolo; Accardi, Francesco

doi:10.1016/j.jacc.2007.09.004

Cited by 115 publications

(87 citation statements)

References 41 publications

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“…Although MTWA has been promoted as a predictor of ventricular events, its value is controversial because prospective trial results have been inconsistent [32][33][34] and the optimal population in which it can be used for risk stratification is yet to be determined.…”

Section: Microvolt T-wave Alternansmentioning

confidence: 99%

Sudden Cardiac Death in Heart Failure

Klein¹,

Hsia²

2014

Cardiology Clinics

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Section: Microvolt T-wave Alternansmentioning

confidence: 99%

Sudden Cardiac Death in Heart Failure

Klein¹,

Hsia²

2014

Cardiology Clinics

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“…A test that did not satisfy positive or negative criteria was classified as indeterminate. On the basis of previously published studies, we further classified results as "abnormal" (for positive and indeterminate test results) or "negative" (negative result) (22). If initially an indeterminate result was obtained, immediate retesting was attempted.…”

Section: Mtwa Testing Protocolmentioning

confidence: 99%

Microvolt T-Wave Alternans in End-Stage Renal Disease Patients—Associations with Uremic Cardiomyopathy

Patel¹,

Mark²,

Halliday³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Premature cardiovascular (CV) events, especially sudden cardiac death, are common in ESRD patients and associated with uremic cardiomyopathy. Identification of high-risk patients is difficult. Microvolt T-wave alternans (MTWA) is a noninvasive method of detecting variability in electrocardiogram (ECG) T-wave morphology and is a promising technique for identifying patients at high risk of ventricular tachyarrhythmias. MTWA results of ESRD and hypertensive left ventricular hypertrophy (LVH) patients were assessed to determine the prevalence of abnormal results and associations with uremic cardiomyopathy.Design, setting, participants, & measurements In this single-center observational study, 200 ESRD and 30 LVH patients underwent assessment including CV history, ECG, cardiac magnetic resonance imaging, and an MTWA exercise test. MTWA results were classified as "negative" or "abnormal" on the basis of previously published reports.Results An abnormal MTWA result was more common in ESRD compared with LVH patients (57.5% versus 26.7%, respectively; P ϭ 0.002). In ESRD patients, MTWA was significantly associated with uremic cardiomyopathy, clinical history of atherosclerosis (coronary, cerebral, peripheral) and diabetes mellitus, older age, and hemodialysis therapy. Independent associations with an abnormal MTWA result were older age, macrovascular disease, increased left ventricle (LV) mass, and LV dilation. ConclusionsFeatures of uremic cardiomyopathy are associated with an abnormal MTWA result.

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“…Approximately one-third of the symptomatic patients with LVEF ≤ 0.35 may test MTWA negative 7,12 . However, a non-negative test in the remaining patients may serve as a specific call to action for the patient and referring Stecker et al 31 found that LVEF had been measured in only 17% of 714 cases of SCD.…”

Section: Mtwa As a Guide To Icd Therapymentioning

confidence: 99%

“…Many studies conducted in patients without implanted ICDs have found MTWA to be a highly accurate risk stratifier and, in particular, have found that the rate of ventricular tachyarrhythmic events (VTEs) among patients who test MTWA negative is exceedingly low [1][2][3][4][5][6][7] suggesting that ICD therapy may not benefit such patients 8 . As a result, MTWA has been proposed as a means of guiding implantable cardioverter defibrillator (ICD) therapy in patients with risk factors for SCD but without a prior history of sustained VTEs (primary prevention patients).…”

Section: Introductionmentioning

confidence: 99%