Abstract
Background/aimThe number of patients with heart transplantation has dramatically increased in the last decade. Considerable studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (Tp-e) may correspond to the transmural dispersion of repolarization and increased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. We analyzed the dispersion of myocardial repolarization using electrocardiographic Tp-e interval and Tp-e/QTc ratio in patients with heart transplantation. Materials and methodsThis observational study included 38 patients (12 female and 26 male) with heart transplantation and 38 well-matched controls. From electrocardiograms, Tp-e interval and Tp-e/QTc ratio were calculated and compared between the 2 groups.ResultsNoninvasive arrhythmia indicators including Tp-e interval (84.63 ± 14.17 ms vs 71.82 ± 7.47 ms, P < 0.001), Tp-e/QTc ratio (0.19 ± 0.04 vs 0.16 ± 0.02, P < 0.001) and QTc interval except QT interval were significantly higher in transplanted hearts compared to normal hearts.ConclusionPatients with heart transplantation have increased myocardial dispersion of repolarization.
Highlights
Despite advances in pharmacologic and device treatment of chronic heart failure, long-term morbidity and mortality remain high and many patients progress to end-stage heart failure
Noninvasive arrhythmia indicators including Tp-e interval (84.63 ± 14.17 ms vs 71.82 ± 7.47 ms, P < 0.001), Tp-e/QTc ratio (0.19 ± 0.04 vs 0.16 ± 0.02, P < 0.001) and QTc interval except QT interval were significantly higher in transplanted hearts compared to normal hearts
As compared with the control group, Tp-e/QTc ratio was significantly higher in leads V6 and DII (P < 0.005) and there was a trend to be higher in lead V2 (P = 0.06)
Summary
Despite advances in pharmacologic and device treatment of chronic heart failure, long-term morbidity and mortality remain high and many patients progress to end-stage heart failure. Over the last 5 decades, heart transplantation (HTx) has become the preferred therapy for selected patients with end-stage heart disease. Arrhythmias are increasingly recognized and significantly affecting quality of life, morbidity, and survival. Many parameters that predict the risk for ventricular arrhythmia (VA) in these patients can be assessed using surface ECG. Tp-e interval indicating indirect measurement of transmural dispersion of repolarization is an measurable parameter, which has been attributed to arrhythmogenesis [1,2]. To the best of our knowledge, there is no data regarding such arrhythmia indicators in patients with heart transplantation. We aimed to investigate noninvasive ECG arrhythmia parameters in transplanted hearts
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