Tp-e interval and Tp-e/QTc ratio as novel surrogate markers for prediction of ventricular arrhythmic events in hypertrophic cardiomyopathyMehmet Kadri Akboða, Kevser Gücihan Balcý, Samet Yýlmaz, Selahattin Aydýn, Çaðrý Yayla, Ahmet Göktuð Ertem, Sefa Ünal, Mustafa Mücahit Balcý, Yücel Balbay, Dursun Aras, Serkan Topaloðlu
Department of Cardiology, Türkiye Yüksek Ýhtisas Training and Research Hospital; Ankara-Turkey
Objective: Hypertrophic cardiomyopathy (HCM) as a common genetic heart disease characterized by ventricular hypertrophy and myocardial fibrosis is significantly associated with a higher risk of fatal ventricular arrhythmic events (VAEs). We aimed to assess the interval between the peak and the end of the electrocardiographic T wave (Tp–e) and Tp–e/corrected QT (QTc) ratio as candidate markers of ventricular arrhythmias in patients with HCM.Keywords: Tp–e interval, Tp–e/QTc ratio, ventricular arrhythmia, hypertrophic cardiomyopathy
Methods: In this single-center, prospective study, a total of 66 patients with HCM and 88 controls were enrolled. The patients were divided into two groups: those with VAEs (n=26) and those without VAEs (n=40). Tp–e interval and Tp–e/QTc ratio were measured using a 12-lead electrocardiogram.
Results: Tp–e interval was significantly longer and Tp–e/QTc ratio were significantly higher in HCM patients than in the controls. In correlation analysis, maximal left ventricular (LV) thickness also has a significant positive correlation with Tp–e interval (r=0.422, p<0.001) and Tp–e/QTc ratio (r=0.348, p<0.001). Finally, multivariable regression analysis showed that a history of syncope, Tp–e interval [OR (odds ratio): 1.060; 95% confidence interval (CI): 1.005–1.117); p=0.012], Tp–e/QTc ratio (OR: 1.148; 95% CI: 1.086–1.204); p=0.049], and maximal LV thickness were independent predictors of VAEs in patients with HCM.
Conclusion: Our findings suggested that prolonged Tp–e interval and increased Tp–e/QTc ratio may be good surrogate markers for the prediction of VAEs in HCM. (Anatol J Cardiol 2017; 17: 000-00)
Corresponding Author: Mehmet Kadri Akboða, Türkiye