Temporal variability of T‐wave morphology and risk of sudden cardiac death in patients with coronary artery disease

Abstract Background The possible relationship between temporal variability of electrocardiographic spatial heterogeneity of repolarization and the risk of sudden cardiac death (SCD) in patients with coronary artery disease (CAD) is not completely understood. Methods The standard deviation of T‐wave...

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Main Authors: Janne T. Rahola, Antti M. Kiviniemi, Olavi H. Ukkola, Mikko P. Tulppo, M. Juhani Junttila, Heikki V. Huikuri, Tuomas V. Kenttä, Juha S. Perkiömäki
Format: Article
Language:English
Published: Wiley 2021-05-01
Series:Annals of Noninvasive Electrocardiology
Subjects:
Online Access:https://doi.org/10.1111/anec.12830
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spelling doaj-b68a7968ed4e4e959f0ebaa6ee491e112021-06-16T06:25:24ZengWileyAnnals of Noninvasive Electrocardiology1082-720X1542-474X2021-05-01263n/an/a10.1111/anec.12830Temporal variability of T‐wave morphology and risk of sudden cardiac death in patients with coronary artery diseaseJanne T. Rahola0Antti M. Kiviniemi1Olavi H. Ukkola2Mikko P. Tulppo3M. Juhani Junttila4Heikki V. Huikuri5Tuomas V. Kenttä6Juha S. Perkiömäki7Research Unit of Internal Medicine Medical Research Center Oulu University of Oulu and Oulu University Hospital Oulu FinlandResearch Unit of Internal Medicine Medical Research Center Oulu University of Oulu and Oulu University Hospital Oulu FinlandResearch Unit of Internal Medicine Medical Research Center Oulu University of Oulu and Oulu University Hospital Oulu FinlandDepartment of Physiology Research Unit of Biomedicine Faculty of Medicine, University of Oulu Oulu FinlandResearch Unit of Internal Medicine Medical Research Center Oulu University of Oulu and Oulu University Hospital Oulu FinlandResearch Unit of Internal Medicine Medical Research Center Oulu University of Oulu and Oulu University Hospital Oulu FinlandResearch Unit of Internal Medicine Medical Research Center Oulu University of Oulu and Oulu University Hospital Oulu FinlandResearch Unit of Internal Medicine Medical Research Center Oulu University of Oulu and Oulu University Hospital Oulu FinlandAbstract Background The possible relationship between temporal variability of electrocardiographic spatial heterogeneity of repolarization and the risk of sudden cardiac death (SCD) in patients with coronary artery disease (CAD) is not completely understood. Methods The standard deviation of T‐wave morphology dispersion (TMD‐SD), of QRST angle (QRSTA‐SD), and of T‐wave area dispersion (TW‐Ad‐SD) were analyzed on beat‐to‐beat basis from 10 min period of the baseline electrocardiographic recording in ARTEMIS study patients with angiographically verified CAD. Results After on average of 8.6 ± 2.3 years of follow‐up, a total of 66 of the 1,678 present study subjects (3.9%) had experienced SCD or were resuscitated from sudden cardiac arrest (SCA). TMD‐SD was most closely associated with the risk for SCD and was significantly higher in patients who had experienced SCD/SCA compared with those who remained alive (3.61 ± 2.83 vs. 2.64 ± 2.52, p = .008, respectively), but did not differ significantly between the patients who had experienced non‐SCD (n = 71, 4.2%) and those who remained alive (3.20 ± 2.73 vs. 2.65 ± 2.53, p = .077, respectively) or between the patients who succumbed to non‐cardiac death (n = 164, 9.8%) and those who stayed alive (2.64 ± 2.17 vs. 2.68 ± 2.58, p = .853). After adjustments with relevant clinical risk indicators of SCD/SCA, TMD‐SD still predicted SCD/SCA (HR 1.107, 95% CIs 1.035–1.185, p = .003). Conclusions Temporal variability of electrocardiographic spatial heterogeneity of repolarization represented by TMD‐SD independently predicts long‐term risk of SCD/SCA in patients with CAD.https://doi.org/10.1111/anec.12830electrocardiographyrepolarizationsudden cardiac deathT‐waveT‐wave morphology
collection DOAJ
language English
format Article
sources DOAJ
author Janne T. Rahola
Antti M. Kiviniemi
Olavi H. Ukkola
Mikko P. Tulppo
M. Juhani Junttila
Heikki V. Huikuri
Tuomas V. Kenttä
Juha S. Perkiömäki
spellingShingle Janne T. Rahola
Antti M. Kiviniemi
Olavi H. Ukkola
Mikko P. Tulppo
M. Juhani Junttila
Heikki V. Huikuri
Tuomas V. Kenttä
Juha S. Perkiömäki
Temporal variability of T‐wave morphology and risk of sudden cardiac death in patients with coronary artery disease
Annals of Noninvasive Electrocardiology
electrocardiography
repolarization
sudden cardiac death
T‐wave
T‐wave morphology
author_facet Janne T. Rahola
Antti M. Kiviniemi
Olavi H. Ukkola
Mikko P. Tulppo
M. Juhani Junttila
Heikki V. Huikuri
Tuomas V. Kenttä
Juha S. Perkiömäki
author_sort Janne T. Rahola
title Temporal variability of T‐wave morphology and risk of sudden cardiac death in patients with coronary artery disease
title_short Temporal variability of T‐wave morphology and risk of sudden cardiac death in patients with coronary artery disease
title_full Temporal variability of T‐wave morphology and risk of sudden cardiac death in patients with coronary artery disease
title_fullStr Temporal variability of T‐wave morphology and risk of sudden cardiac death in patients with coronary artery disease
title_full_unstemmed Temporal variability of T‐wave morphology and risk of sudden cardiac death in patients with coronary artery disease
title_sort temporal variability of t‐wave morphology and risk of sudden cardiac death in patients with coronary artery disease
publisher Wiley
series Annals of Noninvasive Electrocardiology
issn 1082-720X
1542-474X
publishDate 2021-05-01
description Abstract Background The possible relationship between temporal variability of electrocardiographic spatial heterogeneity of repolarization and the risk of sudden cardiac death (SCD) in patients with coronary artery disease (CAD) is not completely understood. Methods The standard deviation of T‐wave morphology dispersion (TMD‐SD), of QRST angle (QRSTA‐SD), and of T‐wave area dispersion (TW‐Ad‐SD) were analyzed on beat‐to‐beat basis from 10 min period of the baseline electrocardiographic recording in ARTEMIS study patients with angiographically verified CAD. Results After on average of 8.6 ± 2.3 years of follow‐up, a total of 66 of the 1,678 present study subjects (3.9%) had experienced SCD or were resuscitated from sudden cardiac arrest (SCA). TMD‐SD was most closely associated with the risk for SCD and was significantly higher in patients who had experienced SCD/SCA compared with those who remained alive (3.61 ± 2.83 vs. 2.64 ± 2.52, p = .008, respectively), but did not differ significantly between the patients who had experienced non‐SCD (n = 71, 4.2%) and those who remained alive (3.20 ± 2.73 vs. 2.65 ± 2.53, p = .077, respectively) or between the patients who succumbed to non‐cardiac death (n = 164, 9.8%) and those who stayed alive (2.64 ± 2.17 vs. 2.68 ± 2.58, p = .853). After adjustments with relevant clinical risk indicators of SCD/SCA, TMD‐SD still predicted SCD/SCA (HR 1.107, 95% CIs 1.035–1.185, p = .003). Conclusions Temporal variability of electrocardiographic spatial heterogeneity of repolarization represented by TMD‐SD independently predicts long‐term risk of SCD/SCA in patients with CAD.
topic electrocardiography
repolarization
sudden cardiac death
T‐wave
T‐wave morphology
url https://doi.org/10.1111/anec.12830
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