Relationship between the QT indices and the microvolt-level T wave alternans in cardiomyopathy.
The relationship between the QT indices and microvolt-level T wave alternans (TWA) is unknown in cardiomyopathy, so the present study examined 86 patients with cardiomyopathy who experienced TWA during exercise testing (EXT). The QT interval (QT), duration from the Q wave to the peak of the T wave (QTp), duration from the peak to the end of the T wave and the dispersion of these parameters were measured by 12-lead electrocardiogram at rest and during EXT. In dilated cardiomyopathy (DCM), TWA was positive (TWA+) in 19 patients and negative (TWA-) in 17. No significant difference was observed between the TWA+ and TWA- groups in any parameter. In hypertrophic cardiomyopathy (HCM), TWA was positive in 24 patients and negative in 12. Max QTc, max QTpc and mean QTpc during EXT in the TWA+ group were significantly longer than those in the TWA- group. The sensitivity of TWA for ventricular tachycardia (VT) was high in DCM and HCM, and that of max QTc >500 ms during EXT for VT was high in HCM (93%). TWA is a useful predictor for VT in DCM and HCM, and prolonged max QTc during exercise has a prognostic value in HCM. Repolarization abnormality during exercise plays an important role in the genesis of VT in cardiomyopathy.
Kuroda
N
N
Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
Ohnishi
Y
Y
Adachi
K
K
Yokoyama
M
M
D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000503:physiopathology*; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis / Q000503:physiopathology; D004562:Electrocardiography / Q000379:methods*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology