Exercise-induced quantitative microvolt T-wave altemans in hypertrophic cardiomyopathy

Author(s)

Antunes, Murillo de Oliveira ; Samesima, Nelson ; Pereira Filho, Horacio Gomes ; Matsumoto, Afonso Yoshikiro ; Verrier, Richard L. ; Pastore, Carlos Alberto ; Arteaga-Fernandez, Edmund ; Mady, Charles

• Document type: Journal article
• Source: JOURNAL OF ELECTROCARDIOLOGY; v. 50, n. 2, p. 184-190, MAR-APR 2017.
• Web of Science Citations: 7

Abstract

Background/Purpose: Patients with hypertrophic cardiomyopathy (HCM) have elevated risk for sudden cardiac death (SCD). Our study aimed to quantitatively characterize microvolt T-wave alternans (TWA), a potential arrhythmia risk stratification tool, in this HCM patient population. Methods: TWA was analyzed with the quantitative modified moving average (MMA) in 132 HCM patients undergoing treadmill exercise testing, grouped according to Maron score risk factors as high-risk (H-Risk, n = 67,), or low-risk (L-Risk, n = 65, without these risk factors). Results: TWA levels were much higher for the H-Risk than for the L-Risk group (101.40 +/- 75.61 vs. 54.35 +/- 46.26 mu V; p < 0.0001). A 53 mu V cut point, set by receiver operator characteristic (ROC), identified H-Risk patients (82% sensitivity, 69% specificity). Conclusions: High TWA levels were found for hypertrophic cardiomyopathy patients. Abnormal TWA associated with major risk factors for SCD: non-sustained ventricular tachycardia on Holter (p = 0.001), family history of SCD (p = 0.006), septal thickness >= 30 mm (p < 0.001); and inadequate blood pressure response to effort (p = 0.04). (C) 2016 Elsevier Inc. All rights reserved. (AU)

• FAPESP's process: 09/17811-6 - Characterization of the profile of microvolt T wave in hypertrophic cardiomyopathy
• Grantee: Edmundo Arteaga-Fernández
• Support Opportunities: Regular Research Grants