TY - JOUR
T1 - The Tpeak − Tend interval as an electrocardiographic risk marker of arrhythmic and mortality outcomes
T2 - A systematic review and meta-analysis
AU - Tse, Gary
AU - Gong, Mengqi
AU - Wong, Wing Tak
AU - Georgopoulos, Stamatis
AU - Letsas, Konstantinos P.
AU - Vassiliou, Vassilios S.
AU - Chan, Yat Sun
AU - Yan, Bryan P.
AU - Wong, Sunny Hei
AU - Wu, William K.K.
AU - Ciobanu, Ana
AU - Li, Guangping
AU - Shenthar, Jayaprakash
AU - Saguner, Ardan M.
AU - Ali-Hasan-Al-Saegh, Sadeq
AU - Bhardwaj, Aishwarya
AU - Sawant, Abhishek C.
AU - Whittaker, Paula
AU - Xia, Yunlong
AU - Yan, Gan Xin
AU - Liu, Tong
N1 - Publisher Copyright:
© 2017 Heart Rhythm Society
PY - 2017/8
Y1 - 2017/8
N2 - Background The Tpeak − Tend interval (the interval from the peak to the end of the T wave), an electrocardiographic marker reflecting transmural dispersion of repolarization, has been used to predict ventricular tachycardia/fibrillation (VT/VF) and sudden cardiac death in different clinical settings. Objective This systematic review and meta-analysis evaluated the significance of the Tpeak − Tend interval in predicting arrhythmic and/or mortality end points. Methods PubMed, Embase, Cochrane Library, and CINAHL Plus databases were searched through November 30, 2016. Results Of the 854 studies identified initially, 33 observational studies involving 155,856 patients were included in our meta-analysis. Tpeak − Tend interval prolongation (mean cutoff value 103.3 ± 17.4 ms) was a significant predictor of the arrhythmic or mortality outcomes (odds ratio [OR] 1.14; 95% confidence interval [CI] 1.11–1.17; P <.001). When different end points were analyzed, the ORs were as follows: VT/VF, 1.10 (95% CI 1.06–1.13; P <.0001); sudden cardiac death, 1.27 (95% CI 1.17–1.39; P <.0001); cardiovascular death, 1.40 (95% CI 1.19–1.64; P <.0001); and all-cause mortality, 4.56 (95% CI 0.62–33.68; P <.0001). Subgroup analysis for each disease revealed that the risk of VT/VF or death was highest for Brugada syndrome (OR 5.68; 95% CI 1.57–20.53; P <.01), followed by hypertension (OR 1.52; 95% CI 1.26–1.85; P <.0001), heart failure (OR 1.07; 95% CI 1.04–1.11; P <.0001), and ischemic heart disease (OR 1.06; 95% CI 1.02–1.10; P = 0.001). Conclusion The Tpeak − Tend interval is a useful risk stratification tool in different diseases and in the general population.
AB - Background The Tpeak − Tend interval (the interval from the peak to the end of the T wave), an electrocardiographic marker reflecting transmural dispersion of repolarization, has been used to predict ventricular tachycardia/fibrillation (VT/VF) and sudden cardiac death in different clinical settings. Objective This systematic review and meta-analysis evaluated the significance of the Tpeak − Tend interval in predicting arrhythmic and/or mortality end points. Methods PubMed, Embase, Cochrane Library, and CINAHL Plus databases were searched through November 30, 2016. Results Of the 854 studies identified initially, 33 observational studies involving 155,856 patients were included in our meta-analysis. Tpeak − Tend interval prolongation (mean cutoff value 103.3 ± 17.4 ms) was a significant predictor of the arrhythmic or mortality outcomes (odds ratio [OR] 1.14; 95% confidence interval [CI] 1.11–1.17; P <.001). When different end points were analyzed, the ORs were as follows: VT/VF, 1.10 (95% CI 1.06–1.13; P <.0001); sudden cardiac death, 1.27 (95% CI 1.17–1.39; P <.0001); cardiovascular death, 1.40 (95% CI 1.19–1.64; P <.0001); and all-cause mortality, 4.56 (95% CI 0.62–33.68; P <.0001). Subgroup analysis for each disease revealed that the risk of VT/VF or death was highest for Brugada syndrome (OR 5.68; 95% CI 1.57–20.53; P <.01), followed by hypertension (OR 1.52; 95% CI 1.26–1.85; P <.0001), heart failure (OR 1.07; 95% CI 1.04–1.11; P <.0001), and ischemic heart disease (OR 1.06; 95% CI 1.02–1.10; P = 0.001). Conclusion The Tpeak − Tend interval is a useful risk stratification tool in different diseases and in the general population.
KW - Dispersion of repolarization
KW - Risk stratification
KW - Sudden cardiac death
KW - T − T
KW - Ventricular arrhythmia
UR - http://www.scopus.com/inward/record.url?scp=85026467922&partnerID=8YFLogxK
U2 - 10.1016/j.hrthm.2017.05.031
DO - 10.1016/j.hrthm.2017.05.031
M3 - Article
C2 - 28552749
AN - SCOPUS:85026467922
SN - 1547-5271
VL - 14
SP - 1131
EP - 1137
JO - Heart Rhythm
JF - Heart Rhythm
IS - 8
ER -