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. 2019 Sep;24(5):e12672.
doi: 10.1111/anec.12672. Epub 2019 Jun 1.

The relationship between myocardial fibrosis detected by cardiac magnetic resonance and Tp-e interval, 5-year sudden cardiac death risk score in hypertrophic cardiomyopathy patients

Ali Riza Demir  1 , Ömer Celik  1 , Samet Sevinç  2 , Begüm Uygur  1 , Serkan Kahraman  1 , Emre Yilmaz  1 , Mete Cemek  3 , Yilmaz Onal  4 , Mehmet Erturk  1
Affiliations

The relationship between myocardial fibrosis detected by cardiac magnetic resonance and Tp-e interval, 5-year sudden cardiac death risk score in hypertrophic cardiomyopathy patients

Ali Riza Demir et al. Ann Noninvasive Electrocardiol. 2019 Sep.

Abstract

Background: The aim of this study was to investigate the relationship between QT (QTc) interval, Tp-e interval, Tp-e/QTc ratio, 5-year sudden cardiac death (SCD) risk score, and late gadolinium enhancement (LGE) detected by CMR in hypertrophic cardiomyopathy (HCM) patients.

Method: A total of 74 consecutive patients who underwent CMR with HCM diagnosis were included in the study. These patients were divided into two groups according to the presence of LGE on CMR. All patients underwent detailed echocardiography and QTc interval, Tp-e interval, and Tp-e/QTc ratios and 5-year SCD risk scores were calculated. These parameters were compared for two groups.

Results: CMR revealed LGE in 32 (43.2%) of 74 HCM patients. In the group with LGE, significantly higher QTc interval (p = 0.002), Tp-e interval (p < 0.001), Tp-e/QTc ratio (p = 0.004), and 5-year SCD risk score were detected. In addition, QTc interval, Tp-e interval, Tp-e/QTc ratio, maximum wall thickness, left ventricular mass index, 5-year SCD risk score, and cardiac fibrosis index were found to be correlated with various degrees in correlation analysis. Also, Tp-e interval is found to be an independent predictor of LGE detected by CMR in HCM patients (p = 0.017, OR [%95 CI] = 1.017 [1.001-1.034]). In addition, the Tp-e interval can detect the LGE with a sensitivity of 64.3% and a specificity of 84.2% at 99.4 ms. (p < 0.001, AUC [95% CI] = 0.790 [0.676-0.905]).

Conclusion: The Tp-e interval can be used to optimize SCD risk stratification in HCM patients and determine which patients will benefit from implantable cardioverter-defibrillator (ICD) treatment.

Keywords: Tp-e interval; cardiac magnetic resonance; hypertrophic cardiomyopathy; late gadolinium enhancement; sudden cardiac death.

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Figures

Figure 1
Figure 1
Tp‐e interval for the presence of LGE in CMR ROC curve; AUC, area under curves; CI, confidence interval; ROC, receiver operator characteristic
See this image and copyright information in PMC

References

    1. Adabag, A. S. , Maron, B. J. , Appelbaum, E. , Harrigan, C. J. , Buros, J. L. , Gibson, C. M. , … Maron, M. S. (2008). Occurrence and frequency of arrhythmias in hypertrophic cardiomyopathy in relation to delayed enhancement on cardiovascular magnetic resonance. Journal of the American College of Cardiology, 51(14), 1369–1374. 10.1016/j.jacc.2007.11.071 - DOI - PubMed
    1. Akboğa, M. K. , Balcı, K. G. , Yılmaz, S. , Aydın, S. , Yayla, Ç. , Ertem, A. G. , Topaloğlu, S. (2017). Tp‐e interval and Tp‐e/QTc ratio as novel surrogate markers for prediction of ventricular arrhythmic events in hypertrophic cardiomyopathy. Anatolian Journal of Cardiology, 18(1), 48 10.14744/AnatolJCardiol.2017.7581. - DOI - PMC - PubMed
    1. Antzelevitch, C. , Sicouri, S. , Di Diego, J. M. , Burashnikov, A. , Viskin, S. , Shimizu, W. , … Zhang, L. I. (2007). Does Tpeak‐Tend provide an index of transmural dispersion of repolarization? Heart Rhythm: the Official Journal of the Heart Rhythm Society, 4(8), 1114–1116. 10.1016/j.hrthm.2007.05.028 - DOI - PMC - PubMed
    1. Bos, J. M. , Towbin, J. A. , & Ackerman, M. J. (2009). Diagnostic, prognostic, and therapeutic implications of genetic testing for hypertrophic cardiomyopathy. Journal of the American College of Cardiology, 54(3), 201–211. 10.1016/j.jacc.2009.02.075 - DOI - PubMed
    1. Bruder, O. , Wagner, A. , Jensen, C. J. , Schneider, S. , Ong, P. , Kispert, E.‐M. , … Mahrholdt, H. (2010). Myocardial scar visualized by cardiovascular magnetic resonance imaging predicts major adverse events in patients with hypertrophic cardiomyopathy. Journal of the American College of Cardiology, 56(11), 875–887. 10.1016/j.jacc.2010.05.007 - DOI - PubMed