PMID- 16207545
OWN - NLM
STAT- MEDLINE
DCOM- 20060228
LR  - 20071115
IS  - 0167-5273 (Print)
IS  - 0167-5273 (Linking)
VI  - 105
IP  - 1
DP  - 2005 Oct 20
TI  - Predictive significance for sudden death of microvolt-level T wave alternans in 
      New York Heart Association class II congestive heart failure patients: a 
      prospective study.
PG  - 53-7
AB  - BACKGROUND: Sudden cardiac death (SDC) is responsible for approximately 60-70% of 
      deaths in New York Heart Association (NYHA) class II congestive heart failure 
      (CHF) patients. Recently, microvolt-level T wave alternans has been proposed as a 
      new noninvasive tool to identify CHF patients at risk for SCD and ventricular 
      tachycardia/fibrillation (VT/VF). OBJECTIVES: To determine the prognostic value 
      of MTWA in NYHA class II patients. METHODS: Among 181 consecutive CHF patients 
      with ischemic and nonischemic cardiomyopathy, 73 patients in NYHA class II with 
      left ventricular ejection fraction <45% were selected and prospectively 
      investigated. MTWA was determined during bicycle exercise testing. The study end 
      point was defined as SCD, documented sustained VT/VF and appropriate implantable 
      cardioverter defibrillator (ICD) shock. RESULTS: MTWA was positive in 30 (41%) 
      patients, negative in 26(36%) patients and indeterminate in 17 (23%) patients. 
      During an average follow-up of 17.1+/-7.4 months, seven patients had an 
      arrhythmic event in the MTWA positive group, whereas one and no events occurred 
      in the indeterminate and negative group, respectively. From Kaplan-Meier 
      univariate analysis and multivariate Cox analysis, MTWA was a significant 
      arrhythmic risk stratifier (p=0.01 and p=0.03, respectively). Sensitivity, 
      specificity, negative and positive predictive values of MTWA were 100%, 53%, 100% 
      and 24%, respectively. CONCLUSION: Our data suggest that MTWA is a promising 
      predictor of arrhythmic events in NYHA class II CHF patients.
FAU - Baravelli, Massimo
AU  - Baravelli M
AD  - Department of Cardiology, University of Insubria, Clinical Institute Mater 
      Domini, Castellanza (VA), Italy. massimo.baravelli@virgilio.it
FAU - Salerno-Uriarte, Diego
AU  - Salerno-Uriarte D
FAU - Guzzetti, Daniela
AU  - Guzzetti D
FAU - Rossi, Maria Cristina
AU  - Rossi MC
FAU - Zoli, Laura
AU  - Zoli L
FAU - Forzani, Teresio
AU  - Forzani T
FAU - Salerno-Uriarte, Jorge A
AU  - Salerno-Uriarte JA
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
CIN - Int J Cardiol. 2007 Jun 25;119(1):127-8; author reply 129-30. PMID: 17049385
MH  - Aged
MH  - Arrhythmias, Cardiac/etiology/physiopathology
MH  - Cardiomyopathies/classification/complications/therapy
MH  - Death, Sudden, Cardiac/*etiology
MH  - Defibrillators, Implantable
MH  - *Electrocardiography
MH  - Exercise Test
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/classification/*complications/therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Myocardial Ischemia/complications/physiopathology/therapy
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Factors
MH  - Stroke Volume/physiology
MH  - Treatment Outcome
EDAT- 2005/10/07 09:00
MHDA- 2006/03/01 09:00
CRDT- 2005/10/07 09:00
PHST- 2004/03/23 00:00 [received]
PHST- 2004/10/10 00:00 [revised]
PHST- 2004/12/30 00:00 [accepted]
PHST- 2005/10/07 09:00 [pubmed]
PHST- 2006/03/01 09:00 [medline]
PHST- 2005/10/07 09:00 [entrez]
AID - S0167-5273(05)00213-5 [pii]
AID - 10.1016/j.ijcard.2004.12.026 [doi]
PST - ppublish
SO  - Int J Cardiol. 2005 Oct 20;105(1):53-7. doi: 10.1016/j.ijcard.2004.12.026.