Abstract:
INTRODUCTION:We examined whether quantification of T-wave alternans (TWA) enhances this parameter's capacity to evaluate the risk for total and cardiovascular mortality and sudden cardiac death (SCD). METHODS AND RESULTS:The Finnish Cardiovascular Study (FINCAVAS) enrolled consecutive patients (n = 2,119; 1,342 men and 777 women) with a clinically indicated exercise test with bicycle ergometer. TWA (time domain-modified moving average method) was analyzed from precordial leads, and the results were grouped in increments of 10 microV. Hazard ratios (HR) for total and cardiovascular mortality and SCD were estimated for preexercise, routine exercise, and postexercise stages. Cox regression analysis was performed. During follow-up of 47.1 +/- 12.9 months (mean +/- standard deviation [SD]), 126 patients died: 62 were cardiovascular deaths, and 33 of these deaths were sudden. During preexercise, TWA >or= 20 microV predicted the risk for total and cardiovascular mortality (maximum HR >4.4 at 60 microV, P < 0.02 for both). During exercise, HRs of total and cardiovascular mortality were significant when TWA measured >or=50 microV, with 90 microV TWA yielding maximum HRs for total and cardiovascular death of 3.1 (P = 0.03) and 6.4 (P = 0.002), respectively. During postexercise, TWA >or=60 microV indicated risk for total and cardiovascular mortality, with maximum HR of 3.4 at 70 microV (P = 0.01) for cardiovascular mortality. SCD was strongly predicted by TWA levels >or=60 microV during exercise, with maximum HR of 4.6 at 60 microV (P = 0.002), but was not predicted during pre- or postexercise. CONCLUSION:Quantification of TWA enhances its capacity for determination of the risk for total and cardiovascular mortality and SCD in low-risk populations. Its prognostic power is superior during exercise compared to preexercise or postexercise.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Minkkinen M,Kähönen M,Viik J,Nikus K,Lehtimäki T,Lehtinen R,Kööbi T,Turjanmaa V,Kaiser W,Verrier RL,Nieminen Tdoi
10.1111/j.1540-8167.2008.01325.xsubject
Has Abstractpub_date
2009-04-01 00:00:00pages
408-15issue
4eissn
1045-3873issn
1540-8167pii
JCE1325journal_volume
20pub_type
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journal_title:Journal of cardiovascular electrophysiology
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journal_title:Journal of cardiovascular electrophysiology
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journal_title:Journal of cardiovascular electrophysiology
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journal_title:Journal of cardiovascular electrophysiology
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Journal of cardiovascular electrophysiology
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
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更新日期:1998-04-01 00:00:00
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pub_type: 杂志文章,多中心研究
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2006.00464.x
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2002.00794.x
更新日期:2002-08-01 00:00:00
abstract:INTRODUCTION:We compared the efficacy and safety of amiodarone and dronedarone in patients with persistent atrial fibrillation (AF). METHODS:Five hundred and four amiodarone-naïve patients were randomized to receive dronedarone 400 mg bid (n = 249) or amiodarone 600 mg qd for 28 days then 200 mg qd (n = 255) for at le...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2010-06-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2007.01088.x
更新日期:2008-05-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
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更新日期:2018-11-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13151
更新日期:2017-03-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2004.03546.x
更新日期:2004-06-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.2000.tb00315.x
更新日期:2000-02-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2011.02036.x
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2008.01307.x
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pub_type: 杂志文章
doi:10.1111/j.1540-8167.2011.02030.x
更新日期:2011-09-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13187
更新日期:2017-05-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.1999.tb00251.x
更新日期:1999-05-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1994.tb01130.x
更新日期:1994-11-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1111/jce.12000
更新日期:2012-12-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2005.40758.x
更新日期:2005-10-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2011.02129.x
更新日期:2011-12-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14377
更新日期:2020-04-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
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更新日期:2013-07-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2001.00662.x
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