Ventricular late potentials and myocardial fibrosis in hypertrophic cardiomyopathy

Matsuki, Ayumi; Kawasaki, Tatsuya; Kawamata, Hirofumi; Sakai, Chieko; Harimoto, Kuniyasu; Kamitani, Takeshi; Yamano, Michiyo; Matoba, Satoaki

doi:10.1016/j.jelectrocard.2019.10.003

Cited by 6 publications

(1 citation statement)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The ECG patterns showed non-specific change in 75 to 95% of HCM patients ( 3 ). Recent studies found that the severity of ECG abnormalities was associated with structural and functional findings in cardiac magnetic resonance (CMR), including left ventricular mass, myocardial hypertrophy, and fibrosis ( 4 – 7 ). However, whether these ECG abnormalities are related to electrical instability and could identify patients with a higher risk of ventricular arrhythmia (VT) or SCD is still not determined.…”

Section: Introductionmentioning

confidence: 99%

Association of QTc Interval and V4-S Wave With Appropriate ICD Therapy in Hypertrophic Cardiomyopathy

Zhang

Cheng

Niu

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundVentricular arrhythmias in patients with hypertrophic cardiomyopathy (HCM) may lead to sudden cardiac death (SCD). We aimed to investigate the relationship between electrocardiogram (ECG) indicators and the risk of appropriate implantable cardioverter-defibrillator (ICD) therapy in HCM.MethodsThe HCM patients receiving ICD implantation were enrolled consecutively. QT interval correction (QTc) was calculated using Bazett's formula. Long or deep S wave in V4 lead was defined as duration time >50 ms and/or voltage amplitude >0.6 mV. The endpoint in our study was at least one ICD appropriate therapy triggered by ventricular tachyarrhythmia (VT) or ventricular fibrillation (VF), including anti-tachyarrhythmia pacing (ATP) and electrical shock.ResultsA total of 149 patients with HCM (mean age 53 ± 14 years, male 69.8%) were studied. Appropriate ICD therapies occurred in 47 patients (31.5%) during a median follow-up of 2.9 years. Cox regression analysis showed that long or deep S wave in V4 lead [hazard ratio (HR) 1.955, 95% confidence interval (CI) 1.017–3.759, P = 0.045] and QTc interval (HR 1.014, 95% CI 1.008–1.021, P < 0.001) were independent risk factors for appropriate ICD therapy. The ROC showed that the optimal cut-off point value for the QTc interval to predict the appropriate ICD therapy was 464 ms, and the AUC was 0.658 (95% CI 0.544–0.762, P = 0.002). The AUC for S wave anomalies in V4 lead was 0.608 (95% CI 0.511–0.706, P = 0.034). We developed a new model that combined the QTc interval and S wave anomalies in V4 lead based on four patient groups. Patients with QTc ≥464 ms and long or deep V4-S wave had the highest risk of developing appropriate ICD therapy (log-rank P < 0.0001). After adding QTc interval and V4-S wave anomalies into the HCM-risk-SCD model, the prediction effect of the new model was significantly improved, and the NRI was 0.302.ConclusionsIn this HCM cohort, QTc and S wave anomalies in V4 lead were found to be significant and strong predictors of the risk of appropriate ICD therapy. Patients with QTc ≥464 ms and long or deep S wave had the highest risk. After QTc interval and V4-S wave anomalies adding to the HCM-risk-SCD model, the prediction effect is significantly improved.

show abstract

Section: Introductionmentioning

confidence: 99%