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Acute and Chronic Changes and Predictive Value of tpeak-tend for Ventricular Arrhythmia Risk in Cardiac Resynchronization Therapy Patients

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中华医学杂志(英文版) 2016年第18期129卷 2204-2211页

作者： Cong Xue Wei Hua Chi Cai Li-Gang Ding Zhi-Min Liu Xiao-Han Fan Yun-Zi Zhao Shu Zhang Cardiac Arrhythmia Center State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College

Background:Prolongation of the tpeak-tend（TpTe）interval as a measurement of transmural dispersion of repolarization（TDR）is an independent risk factor for chronic heart failure ***,the cardiac resynchronization therapy's（CRT）effect on TDR is ***,this study aimed to evaluate CRTs acute and chronic effects on repolarization ***,we aimed to investigate the relationship between TpTe changes and ventricular ***:The study group consisted of 101 patients treated with CRT-defibrillator（CRT-D）.According to whether TpTe was shortened,patients were grouped at immediate and 1-year follow-up after CRT,*** echocardiogram index and ventricular arrhythmia were observed and compared in these ***:For all patients,TpTe slightly increased immediately after CRT-D implantation,and then decreased at the 1-year follow-up（from107±23 to 110±21 ms within 24 h,to 94±24 ms at 1-year follow-up,F=19.366,P<0.001）.No significant difference in the left ventricular reverse remodeling and ventricular tachycardia/ventricular fibrillation（VT/VF）episodes between the TpTe immediately shortened and TpTe immediately nonshortened ***,patients in the TpTe at 1-year shorten had a higher rate of the left ventricular（LV）reverse remodeling（65%vs.44%,X2=4.495,P=0.038）and less VT/VF episodes（log-rank test,X2=10.207,P=0.001）compared with TpTe 1-year nonshortened *** immediately after CRT-D independently predicted VT/VF episodes at 1-year follow-up（hazard ratio[HR],1.030;P=0.001）.Conclusions:Patients with TpTe shortened at 1-year after CRT had a higher rate of LV reverse remodeling and less VT/VF *** acute changes of TpTe after CRT have minimal value on mechanical reverse remodeling and ventricular arrhythmia.

关键词： Cardiac Resynchronization Therapy Dispersion of Repolarization tpeak-tend interval

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Dispersion of ventricular repolarization: Temporal and spatial

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World Journal of Cardiology 2020年第9期12卷 437-449页

作者： Natalia V Arteyeva Laboratory of Cardiac Physiology Institute of Physiology of Komi Science Centre of the Ural Branch of the Russian Academy of SciencesSyktyvkar 167982Russia

Repolarization heterogeneity(RH)is an intrinsic property of ventricular myocardium and the reason for T-wave formation on electrocardiogram(ECG).Exceeding the physiologically based RH level is associated with appearance of life-threatening ventricular arrhythmias and sudden cardiac *** this regard,an accurate and comprehensive evaluation of the degree of RH parameters is of importance for assessment of heart state and arrhythmic *** review is devoted to comprehensive consideration of RH phenomena in terms of electrophysiological processes underlying RH,cardiac electric field formation during ventricular repolarization,as well as clinical significance of RH and its reflection on ECG *** formation of transmural,apicobasal,left-toright and anterior-posterior gradients of action potential durations and end of repolarization times resulting from the heterogenous distribution of repolarizing ion currents and action potential morphology throughout the heart ventricles,and the different sensitivity of myocardial cells in different ventricular regions to the action of pharmacological agents,temperature,frequency of stimulation,etc.,are being *** review is focused on the fact that RH has different aspects–temporal and spatial,global and local;ECG reflection of various RH aspects and their clinical significance are being *** for comprehensive assessment of ventricular RH using different ECG indices reflecting various RH aspects are presented.

关键词： Temporal Spatial Global and local dispersion of repolarization Action potential duration tpeak-tend interval tpeak-tend dispersion T-vector Arrhythmogenesis

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