T-wave alternans predicts mortality in a population undergoing a clinically indicated exercise test

European Heart Journal

Volumn 28, Issue 19, 2007, Pages 2332-2337

  Nieminen, Tuomo ^a   Lehtimäki, Terho ^a,b   Viik, Jari ^a   Lehtinen, Rami ^a,b,c   Nikus, Kjell ^b   Kööbi, Tiit ^a,b   Niemelä, Kari ^b   Turjanmaa, Väinö ^a,b   Kaiser, Willi ^d   Huhtala, Heini ^e   Verrier, Richard L ^f   Huikuri, Heikki ^g   Kähönen, Mika ^a,b  

^a TAMPERE UNIVERSITY OF TECHNOLOGY   (Finland)

^b TAMPERE UNIVERSITY HOSPITAL   (Finland)

^c TAMPERE UNIVERSITY OF APPLIED SCIENCES   (Finland)

^d GE HEALTHCARE   (Germany)

^e UNIVERSITY OF TAMPERE   (Finland)

^f BETH ISRAEL DEACONESS MEDICAL CENTER   (United States)

^g UNIVERSITY OF OULU   (Finland)

Author keywords

Arrhythmia; Electrocardiography; Exercise; Mortality; Tachyarrhythmia

Indexed keywords

BETA ADRENERGIC RECEPTOR BLOCKING AGENT;

ADULT; ARTICLE; BICYCLE ERGOMETRY; CARDIOVASCULAR DISEASE; CARDIOVASCULAR RISK; CAUSE OF DEATH; CONFIDENCE INTERVAL; CONTROLLED STUDY; CORONARY RISK; DRUG USE; ECG ABNORMALITY; ELECTROCARDIOGRAPHY; EXERCISE TEST; FEMALE; FOLLOW UP; HEART INFARCTION; HEART RATE; HUMAN; MAJOR CLINICAL STUDY; MALE; MORTALITY; MULTIVARIATE ANALYSIS; PATIENT REFERRAL; POPULATION RESEARCH; PREDICTION; PRIORITY JOURNAL; RISK ASSESSMENT; RISK FACTOR; SUDDEN DEATH; T WAVE; T WAVE ALTERANS; TIME SERIES ANALYSIS;

AGED; ARRHYTHMIAS, CARDIAC; CARDIOVASCULAR DISEASES; COHORT STUDIES; DEATH, SUDDEN, CARDIAC; ELECTROCARDIOGRAPHY; EXERCISE TEST; FEMALE; FOLLOW-UP STUDIES; HUMANS; MALE; MIDDLE AGED; MULTIVARIATE ANALYSIS; PREDICTIVE VALUE OF TESTS; PROGNOSIS; RISK FACTORS;

EID: 35148887703     PISSN: 0195668X     EISSN: 15229645     Source Type: Journal    
DOI: 10.1093/eurheartj/ehm271     Document Type: Article

References (32)

1. Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 2002;346:793-801.
2. Mundal R, Kjeldsen SE, Sandvik L, Erikssen G, Thaulow E, Erikssen J. Exercise blood pressure predicts mortality from myocardial infarction. Hypertension 1996;27:324-329.
3. Jouven X, Empana JP, Schwartz PJ, Desnos M, Courbon D, Ducimetiere P. Heart-rate profile during exercise as a predictor of sudden death. N Engl J Med 2005;352:1951-1958.
4. Chinushi M, Restivo M, Caref EB, El-Sherif N. Electrophysiological basis of arrhythmogenicity of QT/T alternans in the long-QT syndrome: tridimensional analysis of the kinetics of cardiac repolarization. Circ Res 1998;83:614-628.
5. Pastore JM, Girouard SD, Laurita KR, Akar FG, Rosenbaum DS. Mechanism linking T-wave alternans to the genesis of cardiac fibrillation. Circulation 1999;99:1385-1394.
6. Narayan SM. T-wave alternans and the susceptibility to ventricular arrhythmias. J Am Coll Cardiol 2006;47:269-281.
7. Gehi AK, Stein RH, Metz LD, Gomes JA. Microvolt T-wave alternans for the risk stratification of ventricular tachyarrhythmic events: a meta-analysis. J Am Coll Cardiol 2005;46:75-82.
8. Sarzi Braga S, Vaninetti R, Laporta A, Picozzi A, Pedretti RF. T wave alternans is a predictor of death in patients with congestive heart failure. Int J Cardiol 2004;93:31-38.
9. Tapanainen JM, Still AM, Airaksinen KE, Huikuri HV. Prognostic significance of risk stratifiers of mortality, including T wave alternans, after acute myocardial infarction: results of a prospective follow-up study. J Cardiovasc Electrophysiol 2001;12:645-652.
10. Bloomfield DM, Bigger JT, Steinman RC, Namerow PB, Parides MK, Curtis AB, Kaufman ES, Davidenko JM, Shinn TS, Fontaine JM. Microvolt T-wave alternans and the risk of death or sustained ventricular arrhythmias in patients with left ventricular dysfunction. J Am Coll Cardiol 2006;47:456-463.
11. Gold MR, Bloomfield DM, Anderson KP, El-Sherif NE, Wilber DJ, Groh WJ, Estes NA III, Kaufman ES, Greenberg ML, Rosenbaum DS. A comparison of T-wave alternans, signal averaged electrocardiography and programmed ventricular stimulation for arrhythmia risk stratification. J Am Coll Cardiol 2000;36:2247-2253.
12. Narayan SM, Smith JM, Schechtman KB, Lindsay BD, Cain ME. T-wave alternans phase following ventricular extrasystoles predicts arrhythmia-free survival. Heart Rhythm 2005;2:234-241.
13. Klingenheben T, Zabel M, D'Agostino RB, Cohen RJ, Hohnloser SH. Predictive value of T-wave alternans for arrhythmic events in patients with congestive heart failure. Lancet 2000;356:651-652.
14. Adachi K, Ohnishi Y, Yokoyama M. Risk stratification for sudden cardiac death in dilated cardiomyopathy using microvolt-level T-wave alternans. Jpn Circ J 2001;65:76-80.
15. Kitamura H, Ohnishi Y, Okajima K, Ishida A, Galeano E, Adachi K, Yokoyama M. Onset heart rate of microvolt-level T-wave alternans provides clinical and prognostic value in nonischemic dilated cardiomyopathy. J Am Coll Cardiol 2002;39:295-300.
16. Grimm W, Liedtke J, Muller HH. Prevalence of potential noninvasive arrhythmia risk predictors in healthy, middle-aged persons. Ann Noninvasive Electrocardiol 2003;8:37-46.
17. Grimm W, Christ M, Bach J, Muller HH, Maisch B. Noninvasive arrhythmia risk stratification in idiopathic dilated cardiomyopathy: results of the Marburg Cardiomyopathy Study. Circulation 2003;108:2883-2891.
18. Hohnloser SH, Ikeda T, Bloomfield DM, Dabbous OH, Cohen RJ. T-wave alternans negative coronary patients with low ejection and benefit from defibrillator implantation. Lancet 2003;362:125-126.
19. Rashba EJ, Osman AF, MacMurdy K, Kirk MM, Sarang S, Peters RW, Shorofsky SR, Gold MR. Influence of QRS duration on the prognostic value of T wave alternans. J Cardiovasc Electrophysiol 2002;13:770-775.
20. Verrier RL, Nearing BD, La Rovere MT, Pinna GD, Mittleman MA, Bigger JT Jr, Schwartz PJ. Ambulatory electrocardiogram-based tracking of T wave alternans in postmyocardial infarction patients to assess risk of cardiac arrest or arrhythmic death. J Cardiovasc Electrophysiol 2003;14:705-711.
21. Ikeda T, Saito H, Tanno K, Shimizu H, Watanabe J, Ohnishi Y, Kasamaki Y, Ozawa Y. T-wave alternans as a predictor for sudden cardiac death after myocardial infarction. Am J Cardiol 2002;89:79-82.
22. Chow T, Kereiakes DJ, Bartone C, Booth T, Schloss EJ, Waller T, Chung ES, Menon S, Nallamothu BK, Chan PS. Prognostic utility of microvolt T-wave alternans in risk stratification of patients with ischemic cardiomyopathy. J Am Coll Cardiol 2006;47:1820-1827.
23. Nearing BD, Verrier RL. Modified moving average analysis of T-wave alternans to predict ventricular fibrillation with high accuracy. J Appl Physiol 2002;92:541-549.
24. Kop WJ, Krantz DS, Nearing BD, Gottdiener JS, Quigley JF, O'Callahan M, DelNegro AA, Friehling TD, Karasik P, Suchday S, Levine J, Verrier RL. Effects of acute mental stress and exercise on T-wave alternans in patients with implantable cardioverter defibrillators and controls. Circulation 2004;109:1864-1869.
25. Shusterman V, Goldberg A, London B. Upsurge in T-wave alternans and nonalternating repolarization instability precedes spontaneous initiation of ventricular tachyarrhythmias in humans. Circulation 2006;113:2880- 2887.
26. Nieminen T, Lehtinen R, Viik J, Lehtimäki T, Niemelä K, Nikus K, Niemi M, Kallio J, Kööbi T, Turjanmaa V, Kähönen M. The Finnish Cardiovascular Study (FINCAVAS): characterising patients with high risk of cardiovascular morbidity and mortality. BMC Cardiovasc Disord 2006;6:9.
27. Mason RE, Likar I. A new system of multiple-lead exercise electrocardiography. Am Heart J 1966;71:196-205.
28. Hostetler B, Xue J, Young B, Kaiser K, Findeis M, Gutterman D. Detect short run of TWA event with time-domain algorithm. Comput Cardiol 2005;32:483-486.
29. Kaiser W, Findeis M, Young B. Improving T-wave alternans measurement quality by reducing noise and artifacts. Comput Cardiol 2004;31:445-448.
30. Bloomfield DM, Hohnloser SH, Cohen RJ. Interpretation and classification of microvolt Twave alternans tests. J Cardiovasc Electrophysiol 2002;13:502-512.
31. Pajunen P, Koukkunen H, Ketonen M, Jerkkola T, Immonen-Räihä P, Kärjä-Koskenkari P, Mähönen M, Niemelä M, Kuulasmaa K, Palomäki P, Mustonen J, Lehtonen A, Arstila M, Vuorenmaa T, Lehto S, Miettinen H, Torppa J, Tuomilehto J, Kesäniemi YA, Pyörälä K, Salomaa V. The validity of the Finnish Hospital Discharge Register and Causes of Death Register data on coronary heart disease. Eur J Cardiovasc Prev Rehabil 2005;12:132-137.
32. Huikuri HV, Castellanos A, Myerburg RJ. Sudden death due to cardiac arrhythmias. N Engl J Med 2001;345:1473-1482.