Delayed repolarization and ventricular tachycardia in patients with heart failure and preserved ejection fraction.

Delayed repolarization and ventricular tachycardia in patients with heart failure and preserved ejection fraction.

Sudden death is the most common mode of mortality in patients with heart failure and preserved ejection fraction (HFpEF). Ventricular arrhythmias (VA) have been suspected as the etiology but the supporting evidence in patients with HFpEF is scarce. We sought to investigate VA prevalence, and to dete...

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Autores principales: Jae Hyung Cho, Derek Leong, Natasha Cuk, Joseph E Ebinger, Catherine Bresee, Sung-Han Yoon, Ashkan Ehdaie, Michael Shehata, Xunzhang Wang, Sumeet S Chugh, Eduardo Marbán, Eugenio Cingolani
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Publicado: Public Library of Science (PLoS) 2021
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spelling oai:doaj.org-article:7b372c0a614d48e9bc0e2592d8000c4d2021-12-02T20:15:22ZDelayed repolarization and ventricular tachycardia in patients with heart failure and preserved ejection fraction.1932-620310.1371/journal.pone.0254641https://doaj.org/article/7b372c0a614d48e9bc0e2592d8000c4d2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254641https://doaj.org/toc/1932-6203Sudden death is the most common mode of mortality in patients with heart failure and preserved ejection fraction (HFpEF). Ventricular arrhythmias (VA) have been suspected as the etiology but the supporting evidence in patients with HFpEF is scarce. We sought to investigate VA prevalence, and to determine if VA are associated with prolonged repolarization, in patients with HFpEF. In a retrospective case-control study design, Cedars-Sinai patients who underwent prolonged ambulatory electrocardiographic monitoring (Zio Patch) between 2016 and 2018 were screened for a clinical diagnosis of HFpEF. Patients with normal diastolic and systolic function who underwent Zio Patch monitoring were also reviewed as controls. Multivariable logistic regression was used to compare the prevalence of rhythm disturbances in patients with and without HFpEF. Ventricular tachycardia (VT) was more prevalent in patients with HFpEF (37% vs. 16% in controls, p = 0.001). Most episodes were non-sustained except for one case of sustained VT in a patient with HFpEF. Covariate-adjusted logistic regression including HFpEF diagnosis, age, sex, body mass index, and the presence of comorbidities revealed that only HFpEF was associated with increased risk of VT (relative risk 2.86, p = 0.023). Subgroup-analyses revealed an association between increased QTc interval and risk of VT (460 ± 38 ms in HFpEF patients with VT vs. 445 ± 28 ms in HFpEF patients without VT, p = 0.03). Non-sustained VT was more prevalent in patients with HFpEF compared to patients without HFpEF, and QTc interval prolongation was associated with VT in HFpEF.Jae Hyung ChoDerek LeongNatasha CukJoseph E EbingerCatherine BreseeSung-Han YoonAshkan EhdaieMichael ShehataXunzhang WangSumeet S ChughEduardo MarbánEugenio CingolaniPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254641 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Jae Hyung Cho
Derek Leong
Natasha Cuk
Joseph E Ebinger
Catherine Bresee
Sung-Han Yoon
Ashkan Ehdaie
Michael Shehata
Xunzhang Wang
Sumeet S Chugh
Eduardo Marbán
Eugenio Cingolani
Delayed repolarization and ventricular tachycardia in patients with heart failure and preserved ejection fraction.
description Sudden death is the most common mode of mortality in patients with heart failure and preserved ejection fraction (HFpEF). Ventricular arrhythmias (VA) have been suspected as the etiology but the supporting evidence in patients with HFpEF is scarce. We sought to investigate VA prevalence, and to determine if VA are associated with prolonged repolarization, in patients with HFpEF. In a retrospective case-control study design, Cedars-Sinai patients who underwent prolonged ambulatory electrocardiographic monitoring (Zio Patch) between 2016 and 2018 were screened for a clinical diagnosis of HFpEF. Patients with normal diastolic and systolic function who underwent Zio Patch monitoring were also reviewed as controls. Multivariable logistic regression was used to compare the prevalence of rhythm disturbances in patients with and without HFpEF. Ventricular tachycardia (VT) was more prevalent in patients with HFpEF (37% vs. 16% in controls, p = 0.001). Most episodes were non-sustained except for one case of sustained VT in a patient with HFpEF. Covariate-adjusted logistic regression including HFpEF diagnosis, age, sex, body mass index, and the presence of comorbidities revealed that only HFpEF was associated with increased risk of VT (relative risk 2.86, p = 0.023). Subgroup-analyses revealed an association between increased QTc interval and risk of VT (460 ± 38 ms in HFpEF patients with VT vs. 445 ± 28 ms in HFpEF patients without VT, p = 0.03). Non-sustained VT was more prevalent in patients with HFpEF compared to patients without HFpEF, and QTc interval prolongation was associated with VT in HFpEF.
format article
author Jae Hyung Cho
Derek Leong
Natasha Cuk
Joseph E Ebinger
Catherine Bresee
Sung-Han Yoon
Ashkan Ehdaie
Michael Shehata
Xunzhang Wang
Sumeet S Chugh
Eduardo Marbán
Eugenio Cingolani
author_facet Jae Hyung Cho
Derek Leong
Natasha Cuk
Joseph E Ebinger
Catherine Bresee
Sung-Han Yoon
Ashkan Ehdaie
Michael Shehata
Xunzhang Wang
Sumeet S Chugh
Eduardo Marbán
Eugenio Cingolani
author_sort Jae Hyung Cho
title Delayed repolarization and ventricular tachycardia in patients with heart failure and preserved ejection fraction.
title_short Delayed repolarization and ventricular tachycardia in patients with heart failure and preserved ejection fraction.
title_full Delayed repolarization and ventricular tachycardia in patients with heart failure and preserved ejection fraction.
title_fullStr Delayed repolarization and ventricular tachycardia in patients with heart failure and preserved ejection fraction.
title_full_unstemmed Delayed repolarization and ventricular tachycardia in patients with heart failure and preserved ejection fraction.
title_sort delayed repolarization and ventricular tachycardia in patients with heart failure and preserved ejection fraction.
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/7b372c0a614d48e9bc0e2592d8000c4d
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