Could T-wave and T peak-end interval be a new prognostic marker for
patients receiving after cardiac resynchronization therapy?
Abstract
Background:In this study, we investigated predictors of favourable
responses to CRT using electrocardiography parameters in heart failure
patients. Methods : Seventy-two patients with heart failure, sinus
rhythm, left bundle branch block and receiving CRT were included in the
study. Patients were classified as “responders” with an improvement in
ejection fraction of 10% and “non-responders” as any patient not
meeting this definition. Electrocardiograms were evaluated before and
after 6 months CRT implantation. Results: There was no difference
between responder and non-responder groups in terms of age,
co-morbidities, medications, pre-implantation ECG parameters
(p>0.05). A number of women CRT-responders higher than
non-responder (25.4 % vs 6 %, p=0.026), and NYHA Class III patients
dominantly in CRT-responder groups (36.9 % vs 29.2 %, p=0.014,
respectively).Post–implantation QRS duration (143.3± 18.6 vs 160.1 ±
29.2 ms), cQT interval (474.8 ± 43.4 vs 502.7 ± 49.6 ms), T-wave (165.6
± 25.7 vs 192.1 ± 25.0 ms) and T peak-end (82.9 ± 13.2 vs 98.1 ± 13.3
ms) values were very shorter in CRT responders group (p<0.05).
In univariate regression analyses showed shortening of QRS, QT interval,
T-wave, Tpeak-end interval associated with favourable response to CRT
(p<0.05). The receiver operating characteristics curve
analyses were showed the optimal cut-off T-wave <182 ms, with
76 % sensitivity, 75 % specificity, and Tpeak-end interval <
92 ms with 80 % sensitivity, for the favourable response CRT
(p<0.05). Conclusion: QRS duration and QT interval narrowing
are known to be associated with favourable outcomes, although the T-wave
duration and T peak-to-end interval may also be considered in heart
failure patients to predict a favourable CRT response.