Tp-e interval and Tp-e/QTc ratio as novel surrogate markers for prediction of ventricular arrhythmic events in hypertrophic cardiomyopathy.
OBJECTIVE
Hypertrophic cardiomyopathy (HCM) as a common genetic heart disease characterized by ventricular hypertrophy and myocardial fibrosis is significantly associated with a higher risk of fatal ventricular arrhythmic events (VAEs). We aimed to assess the interval between the peak and the end of the electrocardiographic T wave (Tp-e) and Tp-e/corrected QT (QTc) ratio as candidate markers of ventricular arrhythmias in patients with HCM.


METHODS
In this single-center, prospective study, a total of 66 patients with HCM and 88 controls were enrolled. The patients were divided into two groups: those with VAEs (n=26) and those without VAEs (n=40). Tp-e interval and Tp-e/QTc ratio were measured using a 12-lead electrocardiogram.


RESULTS
Tp-e interval was significantly longer and Tp-e/QTc ratio were significantly higher in HCM patients than in the controls. In correlation analysis, maximal left ventricular (LV) thickness also has a significant positive correlation with Tp-e interval (r=0.422, p<0.001) and Tp-e/QTc ratio (r=0.348, p<0.001). Finally, multivariable regression analysis showed that a history of syncope, Tp-e interval [OR (odds ratio): 1.060; 95% confidence interval (CI): 1.005-1.117); p=0.012], Tp-e/QTc ratio (OR: 1.148; 95% CI: 1.086-1.204); p=0.049], and maximal LV thickness were independent predictors of VAEs in patients with HCM.


CONCLUSIONS
Our findings suggested that prolonged Tp-e interval and increased Tp-e/QTc ratio may be good surrogate markers for the prediction of VAEs in HCM.
Department of Cardiology, Türkiye Yüksek İhtisas Training and Research Hospital; Ankara-Turkey. mkakboga@yahoo.com.
Mehmet Kadri
MK
Akboğa
Kevser
K
Gülcihan Balcı
Samet
S
Yılmaz
Selahattin
S
Aydın
Çağrı
Ç
Yayla
Ahmet Göktuğ
AG
Ertem
Sefa
S
Ünal
Mustafa Mücahit
MM
Balcı
Yücel
Y
Balbay
Dursun
D
Aras
Serkan
S
Topaloğlu
D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000503:physiopathology; D015415:Biomarkers; D002312:Cardiomyopathy, Hypertrophic; D016022:Case-Control Studies; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests
D015415:Biomarkers