Tp-e interval and Tp-e/QTc ratio as novel surrogate markers for prediction of ventricular arrhythmic events in hypertrophic cardiomyopathy

Akboğa, Mehmet Kadri; Balcı, Kevser Gülcihan; Yılmaz, Samet; Aydın, Selahattin; Yayla, Çağrı; Ertem, Ahmet Göktuğ; Ünal, Sefa; Balcı, Mustafa; Balbay, Yücel; Aras, Dursun; Topaloğlu, Serkan

doi:10.14744/anatoljcardiol.2017.7581

Cited by 26 publications

(26 citation statements)

References 26 publications

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“…Furthermore, in patients with ventricular arrhythmic event (VAE) in the HCM group, the Tp‐e interval and Tp‐e/QTc ratio were significantly higher than patients without VAE and there was a positive correlation with the maximum LVWT and Tp‐e interval and Tp‐e/QTc ratio. In addition, multivariate analysis revealed that these markers were associated with a higher risk of VAE (respectively, OR: 1.060; % 95 CI: 1.005–1.117; p = 0.012 and OR: 1.148; % 95 CI: 1.086–1.204; p = 0.049) (Akboğa et al, ). In Shimizu et al study with 47 HCM patients, they found higher Tp‐e intervals compared to patients without SCD and VT.…”

Section: Discussionmentioning

confidence: 94%

The relationship between myocardial fibrosis detected by cardiac magnetic resonance and Tp‐e interval, 5‐year sudden cardiac death risk score in hypertrophic cardiomyopathy patients

Demir

Çelik

Sevinç

et al. 2019

Noninvasive Electrocardiol

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Background:The aim of this study was to investigate the relationship between QT (QTc) interval, Tp-e interval, Tp-e/QTc ratio, 5-year sudden cardiac death (SCD) risk score, and late gadolinium enhancement (LGE) detected by CMR in hypertrophic cardiomyopathy (HCM) patients.Method: A total of 74 consecutive patients who underwent CMR with HCM diagnosis were included in the study. These patients were divided into two groups according to the presence of LGE on CMR. All patients underwent detailed echocardiography and QTc interval, Tp-e interval, and Tp-e/QTc ratios and 5-year SCD risk scores were calculated. These parameters were compared for two groups.Results: CMR revealed LGE in 32 (43.2%) of 74 HCM patients. In the group with LGE, significantly higher QTc interval (p = 0.002), Tp-e interval (p < 0.001), Tp-e/QTc ratio (p = 0.004), and 5-year SCD risk score were detected. In addition, QTc interval, Tp-e interval, Tp-e/QTc ratio, maximum wall thickness, left ventricular mass index, 5-year SCD risk score, and cardiac fibrosis index were found to be correlated with various degrees in correlation analysis. Also, Tp-e interval is found to be an independent predictor of LGE detected by CMR in HCM patients (p = 0.017, OR [%95 CI] = 1.017 [1.001-1.034]). In addition, the Tp-e interval can detect the LGE with a sensitivity of 64.3% and a specificity of 84.2% at 99.4 ms. (p < 0.001, AUC [95% CI] = 0.790 [0.676-0.905]). Conclusion:The Tp-e interval can be used to optimize SCD risk stratification in HCM patients and determine which patients will benefit from implantable cardioverter-defibrillator (ICD) treatment. K E Y W O R D Scardiac magnetic resonance, hypertrophic cardiomyopathy, late gadolinium enhancement, sudden cardiac death, Tp-e interval

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Section: Discussionmentioning

confidence: 94%

The relationship between myocardial fibrosis detected by cardiac magnetic resonance and Tp‐e interval, 5‐year sudden cardiac death risk score in hypertrophic cardiomyopathy patients

Demir

Çelik

Sevinç

et al. 2019

Noninvasive Electrocardiol

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“…Other important indices like QT, QTc, Tp-Te/QT, Tp-Te/QTc, Tp-Tec/QTc didn’t show any significant difference between groups. When looking into results more precisely in tables, our mean Tp-Te/ QT and Tp-Te/ QTc values in all groups were found higher than important cutoff levels in some trials [8], [24], [31], [32], [34]. But after careful examination, some indices were found meaningful higher than accepted cutoff points according to some trials, mean Tp-Te/QT level in our HFmrEF patients was higher than patients with BS.…”

Section: Discussionmentioning

confidence: 97%

“…They found a cutoff value of Tp-Te ≥ 77 ms and Tp-Te/QT ratio of ≥ 0.205 for predicting cardiac events with a good sensitivity and specificity level [33]. In hypertrophic cardiomyopathy patients with VA events, mean Tp-Te interval and Tp-Te/QTc ratio were longer than without events and control group (Tp-Te: 82.6 ± 9.8 ms vs. 74.6 ± 9.3 ms; Tp-Te/QTc: 0.202 ± 0 vs.0.181 ± 0; P < 0.001 for all) [34]. Another trial which included acute ST-elevation myocardial patients with coronary interventional therapy showed pre-coronary intervention (pre-CI) Tp-Te was prolonged in patients that died during follow-up.…”

Section: Discussionmentioning

confidence: 99%

A Comparing of Tp-Te Interval and Tp-Te/Qt Ratio in Patients with Preserved, Mid-Range and Reduced Ejection Fraction Heart Failure

Son¹,

Boduroğlu²

2019

Open Access Maced J Med Sci

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BACKGROUND: Heart failure (HF) is classified in three class: HF with preserved EF (HFpEF); normal or LVEF ≥ 50%, HF with reduced EF (HFrEF); LEVF < 40% and newly HF mid-range EF (HFmrEF); LVEF 40-49%. On Electrocardiography (ECG) T wave, Tpeak-Tend (Tp-Te) interval reflects transmural dispersion of repolarisation (TDR) which of these indexes have been proposed as predictors of risk for ventricular arrhythmia (VA) in many cardiac diseases. AIM: Aim of this study to asses these indices of TDR among three HF class. METHODS: Total of 192 patients were included in this study. RESULTS: Many of indices like Tp-Te, Tp-Te/QT wasn’t different between groups (P > 0.05). But mean Q-Tpeak (QTp), S-Tend (S-Te) and S-Tpeak (S-Tp) were found significantly different between groups (P < 0.05). Again S-Te was found different according to having fragmented QRS (fQRS) on ECG (P = 0.031). Comparing to mitral inflow E/A parameters showed significant differences for Tp-Te, Tp-Tec, Tp-Te/QT, Tp-Te/QTc and Tp-Tec/QTc parameters. Finally, we found correlations between S-Te and white blood cell (WBC) (r = - 0.171; P = 0.037) and S-Tp and WBC (r = - 0.170; P = 0.038) and between S-Te and fQRS (r = 0.158; P = 0.031). CONCLUSIONS: We didn’t find differences for many of indices of TDR like Tp-Te interval between groups except QTp, S-Te, S-Tp intervals. Also, S-Te and fQRS showed significant correlation. For prediction of ventricular arrhythmia and cardiovascular death newer indexes on ECG are needed to be established in the future which will make us facilitate to distinguish high risk patients.

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“…Previous studies have suggested that increased Tp-Te interval is a risk factor for unsustainable ventricular tachycardia in patients with hypertrophic cardiomyopathy [24]. The latest study by Akbog et al [25] in 2017 Found thatTp-Te interval and Tp-Te / QT can be independent predictors of ventricular arrhythmias in HCM patients. A study by Chinese experts on hypertrophic cardiomyopathy (Tp-Te) confirmed that The Tp-Te interval was significantly shortened after chemoablation.…”

Section: The Hypertrophic Cardiomyopathymentioning

confidence: 97%

Research Progress in Formation and Application of Tp-Te Interval

Yue¹

2019

CCR

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Tp-Te interval refers to the duration from the peak to the end time points of T wave in electrocardiogram. Tp-Te interval is an electrocardiogram index reflecting mail-gnant ventricular arrhythmia, while Tp-Te interval mainly reflects ventricular transmural repolarization dispersion. The increase of ventricular transmural repolarization dispersion makes it easy to appear depolarization after repolarization, and forms functional conduction block between different regions, which leads to malignant arrhythmias. In this review we discuss how these markers have demonstrated to be effective to predict malignant arrhythmias in medical conditions such as long and short QT syndromes, Brugada syndrome and so on. However, the same results have not been found in all conditions. Further studies are needed to reach a global consensus in order to incorporate these VR parameters in risk stratification of these patients.

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Tp-e interval and Tp-e/QTc ratio as novel surrogate markers for prediction of ventricular arrhythmic events in hypertrophic cardiomyopathy

Cited by 26 publications

References 26 publications

The relationship between myocardial fibrosis detected by cardiac magnetic resonance and Tp‐e interval, 5‐year sudden cardiac death risk score in hypertrophic cardiomyopathy patients

The relationship between myocardial fibrosis detected by cardiac magnetic resonance and Tp‐e interval, 5‐year sudden cardiac death risk score in hypertrophic cardiomyopathy patients

A Comparing of Tp-Te Interval and Tp-Te/Qt Ratio in Patients with Preserved, Mid-Range and Reduced Ejection Fraction Heart Failure

Research Progress in Formation and Application of Tp-Te Interval

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