Predictive Value of Tpeak – Tend Indices for Adverse Outcomes in Acquired QT Prolongation: A Meta-Analysis
Background: Acquired QT interval prolongation has been linked with malignant ventricular arrhythmias, such as torsade de pointes, in turn predisposing to sudden cardiac death. Increased dispersion of repolarization has been identified as a pro-arrhythmic factor and can be observed as longer Tpeak –...
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Frontiers Media S.A.
2018-09-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fphys.2018.01226/full |
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| author | Gary Tse Gary Tse Mengqi Gong Lei Meng Cheuk W. Wong George Bazoukis Matthew T. V. Chan Martin C. S. Wong Konstantinos P. Letsas Adrian Baranchuk Gan-Xin Yan Gan-Xin Yan Tong Liu William K. K. Wu |
| author_facet | Gary Tse Gary Tse Mengqi Gong Lei Meng Cheuk W. Wong George Bazoukis Matthew T. V. Chan Martin C. S. Wong Konstantinos P. Letsas Adrian Baranchuk Gan-Xin Yan Gan-Xin Yan Tong Liu William K. K. Wu |
| author_sort | Gary Tse |
| collection | DOAJ |
| description | Background: Acquired QT interval prolongation has been linked with malignant ventricular arrhythmias, such as torsade de pointes, in turn predisposing to sudden cardiac death. Increased dispersion of repolarization has been identified as a pro-arrhythmic factor and can be observed as longer Tpeak – Tend interval and higher Tpeak – Tend/QT ratio on the electrocardiogram. However, the values of these repolarization indices for predicting adverse outcomes in this context have not been systematically evaluated.Method: PubMed, Embase and Cochrane Library databases were searched until 14th February 2018, identifying 232 studies.Results: Five studies on acquired QT prolongation met the inclusion criteria and 308 subjects with drug-induced LQTS patients (mean age: 66 ± 18 years old; 46% male) were included in this meta-analysis. Tpeak – Tend intervals were longer [mean difference [MD]: 76 ms, standard error [SE]: 26 ms, P = 0.003; I2 = 98%] and Tpeak – Tend/QT ratios were higher (MD: 0.14, SE: 0.03, P = 0.000; I2 = 29%) in patients with torsade de pointes compared to those without these events.Conclusion: Tpeak – Tend interval and Tpeak – Tend/QT ratio were higher in patients with acquired QT prolongation suffering from torsade de pointes compared to those who did not. These repolarization indices may provide additional predictive value for identifying high-risk individuals. |
| first_indexed | 2024-12-10T21:35:22Z |
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| language | English |
| last_indexed | 2024-12-10T21:35:22Z |
| publishDate | 2018-09-01 |
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| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-a309f9bfd94441a6b9c4c26965eab7282022-12-22T01:32:40ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2018-09-01910.3389/fphys.2018.01226396514Predictive Value of Tpeak – Tend Indices for Adverse Outcomes in Acquired QT Prolongation: A Meta-AnalysisGary Tse0Gary Tse1Mengqi Gong2Lei Meng3Cheuk W. Wong4George Bazoukis5Matthew T. V. Chan6Martin C. S. Wong7Konstantinos P. Letsas8Adrian Baranchuk9Gan-Xin Yan10Gan-Xin Yan11Tong Liu12William K. K. Wu13Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, Hong KongLi Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, Hong KongTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, Hong KongTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, Hong KongLi Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong KongLaboratory of Cardiac Electrophysiology, Second Department of Cardiology, Evangelismos General Hospital of Athens, Athens, GreeceDepartment of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Hong Kong, Hong KongJC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, Hong KongLaboratory of Cardiac Electrophysiology, Second Department of Cardiology, Evangelismos General Hospital of Athens, Athens, GreeceDivision of Cardiology, Kingston General Hospital, Queen's University, Kingston, ON, CanadaLankenau Institute for Medical Research and Lankenau Medical Center, Wynnewood, PA, United States0Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, Hong KongDepartment of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Hong Kong, Hong KongBackground: Acquired QT interval prolongation has been linked with malignant ventricular arrhythmias, such as torsade de pointes, in turn predisposing to sudden cardiac death. Increased dispersion of repolarization has been identified as a pro-arrhythmic factor and can be observed as longer Tpeak – Tend interval and higher Tpeak – Tend/QT ratio on the electrocardiogram. However, the values of these repolarization indices for predicting adverse outcomes in this context have not been systematically evaluated.Method: PubMed, Embase and Cochrane Library databases were searched until 14th February 2018, identifying 232 studies.Results: Five studies on acquired QT prolongation met the inclusion criteria and 308 subjects with drug-induced LQTS patients (mean age: 66 ± 18 years old; 46% male) were included in this meta-analysis. Tpeak – Tend intervals were longer [mean difference [MD]: 76 ms, standard error [SE]: 26 ms, P = 0.003; I2 = 98%] and Tpeak – Tend/QT ratios were higher (MD: 0.14, SE: 0.03, P = 0.000; I2 = 29%) in patients with torsade de pointes compared to those without these events.Conclusion: Tpeak – Tend interval and Tpeak – Tend/QT ratio were higher in patients with acquired QT prolongation suffering from torsade de pointes compared to those who did not. These repolarization indices may provide additional predictive value for identifying high-risk individuals.https://www.frontiersin.org/article/10.3389/fphys.2018.01226/fullTpeak—TendTpeak—Tend/QTdispersion of repolarizationrisk stratificationventricular arrhythmiasudden cardiac death |
| spellingShingle | Gary Tse Gary Tse Mengqi Gong Lei Meng Cheuk W. Wong George Bazoukis Matthew T. V. Chan Martin C. S. Wong Konstantinos P. Letsas Adrian Baranchuk Gan-Xin Yan Gan-Xin Yan Tong Liu William K. K. Wu Predictive Value of Tpeak – Tend Indices for Adverse Outcomes in Acquired QT Prolongation: A Meta-Analysis Frontiers in Physiology Tpeak—Tend Tpeak—Tend/QT dispersion of repolarization risk stratification ventricular arrhythmia sudden cardiac death |
| title | Predictive Value of Tpeak – Tend Indices for Adverse Outcomes in Acquired QT Prolongation: A Meta-Analysis |
| title_full | Predictive Value of Tpeak – Tend Indices for Adverse Outcomes in Acquired QT Prolongation: A Meta-Analysis |
| title_fullStr | Predictive Value of Tpeak – Tend Indices for Adverse Outcomes in Acquired QT Prolongation: A Meta-Analysis |
| title_full_unstemmed | Predictive Value of Tpeak – Tend Indices for Adverse Outcomes in Acquired QT Prolongation: A Meta-Analysis |
| title_short | Predictive Value of Tpeak – Tend Indices for Adverse Outcomes in Acquired QT Prolongation: A Meta-Analysis |
| title_sort | predictive value of tpeak tend indices for adverse outcomes in acquired qt prolongation a meta analysis |
| topic | Tpeak—Tend Tpeak—Tend/QT dispersion of repolarization risk stratification ventricular arrhythmia sudden cardiac death |
| url | https://www.frontiersin.org/article/10.3389/fphys.2018.01226/full |
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