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Article: Relationship between ventricular dyssynchrony and T-wave alternans in patients with coronary artery disease

TitleRelationship between ventricular dyssynchrony and T-wave alternans in patients with coronary artery disease
Authors
Issue Date2011
PublisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1
Citation
Pace - Pacing And Clinical Electrophysiology, 2011, v. 34 n. 11, p. 1503-1510 How to Cite?
AbstractIntroduction: Coronary artery disease (CAD) is associated with increased dispersion of repolarization and sudden cardiac death. We sought to investigate whether ventricular dyssynchrony is associated with proarrhythmic repolarization dispersion as measured by T-wave alternans (TWA) in patients with CAD. Methods and Results: We evaluated 154 patients (67 ± 9 years, 123 men) with documented CAD, who underwent exercise treadmill testing and echocardiographic examination. TWA was analyzed continuously during treadmill testing in all standard precordial leads by time-domain method. Tissue Doppler imaging was performed to measure inter- and intraventricular dyssynchrony. Increased TWA ≥ 60μV was observed in 42 (27%) patients. There was higher prevalence of females (31 vs 16%, P = 0.04) and greater body mass index (25.7 ± 2.6 vs 24.6 ± 3.0 kg/m 2, P = 0.04) in the TWA ≥ 60μV group of patients than the TWA < 60μV group. The index of interventricular dyssynchrony, Ts-RL, was significantly increased (75.6 ± 37.8 vs 59.9 ± 35.9 ms, P = 0.03) but not intraventricular dyssynchrony (all P > 0.05) in patients with TWA ≥ 60 μV compared with those with TWA < 60 μV. In addition, a weak but significant positive correlation was observed between TWA and Ts-RL (r = 0.25, P = 0.003). Multivariate analysis revealed that only Ts-RL (odds ratio 1.02, 95% confidence interval 1.00-1.03, P = 0.013) was independent predictor for increased TWA. Conclusions: Our results demonstrated that interventricular dyssynchrony in patients with CAD is associated with increased TWA. This suggests that interventricular dyssynchrony may contribute to proarrhythmic repolarization dispersion. © 2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/135215
ISSN
2015 Impact Factor: 1.156
2015 SCImago Journal Rankings: 0.662
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYan, GHen_HK
dc.contributor.authorWang, Men_HK
dc.contributor.authorYue, WSen_HK
dc.contributor.authorYiu, KHen_HK
dc.contributor.authorZhi, Gen_HK
dc.contributor.authorLau, CPen_HK
dc.contributor.authorLee, SWLen_HK
dc.contributor.authorSiu, CWen_HK
dc.contributor.authorTse, HFen_HK
dc.date.accessioned2011-07-27T01:30:04Z-
dc.date.available2011-07-27T01:30:04Z-
dc.date.issued2011en_HK
dc.identifier.citationPace - Pacing And Clinical Electrophysiology, 2011, v. 34 n. 11, p. 1503-1510en_HK
dc.identifier.issn0147-8389en_HK
dc.identifier.urihttp://hdl.handle.net/10722/135215-
dc.description.abstractIntroduction: Coronary artery disease (CAD) is associated with increased dispersion of repolarization and sudden cardiac death. We sought to investigate whether ventricular dyssynchrony is associated with proarrhythmic repolarization dispersion as measured by T-wave alternans (TWA) in patients with CAD. Methods and Results: We evaluated 154 patients (67 ± 9 years, 123 men) with documented CAD, who underwent exercise treadmill testing and echocardiographic examination. TWA was analyzed continuously during treadmill testing in all standard precordial leads by time-domain method. Tissue Doppler imaging was performed to measure inter- and intraventricular dyssynchrony. Increased TWA ≥ 60μV was observed in 42 (27%) patients. There was higher prevalence of females (31 vs 16%, P = 0.04) and greater body mass index (25.7 ± 2.6 vs 24.6 ± 3.0 kg/m 2, P = 0.04) in the TWA ≥ 60μV group of patients than the TWA < 60μV group. The index of interventricular dyssynchrony, Ts-RL, was significantly increased (75.6 ± 37.8 vs 59.9 ± 35.9 ms, P = 0.03) but not intraventricular dyssynchrony (all P > 0.05) in patients with TWA ≥ 60 μV compared with those with TWA < 60 μV. In addition, a weak but significant positive correlation was observed between TWA and Ts-RL (r = 0.25, P = 0.003). Multivariate analysis revealed that only Ts-RL (odds ratio 1.02, 95% confidence interval 1.00-1.03, P = 0.013) was independent predictor for increased TWA. Conclusions: Our results demonstrated that interventricular dyssynchrony in patients with CAD is associated with increased TWA. This suggests that interventricular dyssynchrony may contribute to proarrhythmic repolarization dispersion. © 2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.en_HK
dc.languageengen_US
dc.publisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1en_HK
dc.relation.ispartofPACE - Pacing and Clinical Electrophysiologyen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshComorbidityen_HK
dc.subject.meshCoronary Artery Disease - diagnosis - epidemiologyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHong Kong - epidemiologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshIncidenceen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPrevalenceen_HK
dc.subject.meshRisk Assessmenten_HK
dc.subject.meshRisk Factorsen_HK
dc.subject.meshTachycardia, Ventricular - diagnosis - epidemiologyen_HK
dc.subject.meshVentricular Dysfunction, Left - diagnosis - epidemiologyen_HK
dc.titleRelationship between ventricular dyssynchrony and T-wave alternans in patients with coronary artery diseaseen_HK
dc.typeArticleen_HK
dc.identifier.emailWang, M:meiwang@hkucc.hku.hken_HK
dc.identifier.emailYiu, KH:khkyiu@hku.hken_HK
dc.identifier.emailSiu, CW:cwdsiu@hkucc.hku.hken_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authorityWang, M=rp00281en_HK
dc.identifier.authorityYiu, KH=rp01490en_HK
dc.identifier.authoritySiu, CW=rp00534en_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1111/j.1540-8159.2011.03183.xen_HK
dc.identifier.pmid21797908-
dc.identifier.scopuseid_2-s2.0-81055140538en_HK
dc.identifier.hkuros187162en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-81055140538&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume34en_HK
dc.identifier.issue11en_HK
dc.identifier.spage1503en_HK
dc.identifier.epage1510en_HK
dc.identifier.isiWOS:000297939500012-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridYan, GH=36544693600en_HK
dc.identifier.scopusauthoridWang, M=7406690398en_HK
dc.identifier.scopusauthoridYue, WS=36106565300en_HK
dc.identifier.scopusauthoridYiu, KH=35172267800en_HK
dc.identifier.scopusauthoridZhi, G=7003672763en_HK
dc.identifier.scopusauthoridLau, CP=35275317200en_HK
dc.identifier.scopusauthoridWl Lee, S=43961766500en_HK
dc.identifier.scopusauthoridSiu, CW=7006550690en_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK

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