Microvolt T-wave alternans profiles in patients with pulmonary arterial hypertension compared to patients with left ventricular systolic dysfunction and a group of healthy volunteers.
Microvolt T-wave alternans (MTWA) is a well-examined parameter for the risk stratification of sudden cardiac death (SCD) in patients with left ventricular dysfunction (LVD). However, the role of MTWA in pulmonary arterial hypertension (PAH) remains obscure. Consequently, the present study aimed to analyze the profile of MTWA among PAH patients in comparison with LVD patients and healthy volunteers.



The prospectively study included 22 patients with PAH (mean pulmonary artery pressure ≥ 25 mm Hg and pulmonary capillary wedge pressure ≤15 mm Hg during right heart catheterization; mean age, 40±17 years); 24 with LVD [left ventricular ejection fraction (LVEF) ≤35%; mean age, 40±11 years]; and 28 healthy volunteers (mean age, 41±8 years). Patients with persistent atrial arrhythmia were excluded. The MTWA (spectral method) categories were positive, negative, or indeterminate (MTWA_pos, MTWA_neg, or MTWA_ind, respectively). MTWA_pos and MTWA_ind were qualified as abnormal (MTWA_abn). Statistical analyses (Mann-Whitney U, chi-square with Yates's correction, Fisher's exact test) were performed.



PAH patients had higher LVEF than LVD patients (61±7% vs. 27±7%; p<0.05). MTWA_abn was observed more frequently in the PAH and LVD groups than in the healthy volunteers. Patients with PAH were characterized by a considerable percentage of MTWA_pos and MTWA_abn (59% and 73%, respectively), but this did not differ from LVD patients.



Patients with PAH are characterized by a high rate of MTWA abnormalities similar to LVD patients, despite the relevant differences in LVEF. Further research is required to elucidate the clinical significance and prognostic value of this data, particularly in the context of SCDunderlying mechanisms in PAH patients.
Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdansk-Poland. ludwik@gumed.edu.pl.
Ludmila
L
Danilowicz-Szymanowicz
Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdansk-Poland.
Ewa
E
Lewicka
Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdansk-Poland.
Alicja
A
Dabrowska-Kugacka
Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdansk-Poland.
Agnieszka
A
Niemirycz-Makurat
Department of Pediatric Cardiology and Congenital Heart Defect, Medical University of Gdansk, Gdansk-Poland.
Joanna
J
Kwiatkowska
Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdansk-Poland.
Zuzanna
Z
Lewicka-Potocka
Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdansk-Poland.
Katarzyna
K
Rozwadowska
Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdansk-Poland.
Emilia
E
Stepnowska
Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdansk-Poland.
Grzegorz
G
Raczak
D000328:Adult; D001145:Arrhythmias, Cardiac; D016757:Death, Sudden, Cardiac; D004562:Electrocardiography; D064368:Healthy Volunteers; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications*; D008875:Middle Aged; D010865:Pilot Projects; D018570:Risk Assessment; D018487:Ventricular Dysfunction, Left / Q000150:complications*; D055815:Young Adult