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Role of ventricular repolarization indicators in risk stratification of decompensated heart failure patients with ventricular systolic dysfunction
Mohammad Reza Hatamnejad , Morteza Hosseinpour , Peyman Izad Panah , Mohammad Reza Kasravi , Mehdi Bazrafshan , Hamed Bazrafshan *
Associated Professor, Department of Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran , hamedbazrafshan@yahoo.com
Abstract:   (874 Views)
Background: Ventricular repolarization measurement by QTc interval and QT dispersion can recognize high-risk patients. Previous research tended to evaluate the act of repolarization indicators lonely but this study aimed to elucidate their prognostic utility before and after modifying confounding parameters in risk stratification of different aspects of prognosis in decompensated heart failure patients with systolic dysfunction. Methods: Data of 98 variables were evaluated to determine their predictive value concerning arrhythmic events, in-hospital, and long-term mortality. Results: From 858 cases who presented with acute heart failure, 19.2% (n=165) were enrolled in the study. During hospitalization, arrhythmic events and cardiac-related mortality occurred in 56(33.9%) and 11(7%) patients, respectively. QTc and QT dispersion were independent predictors of arrhythmia and in-hospital mortality after adjustment of the variables (arrhythmic events: QTc interval OR 1.085, 95% CI 1.023-1.151, p=0.007, QT dispersion OR 1.077, 95%CI 1.020-1.137, p=0.007). After being discharged, they were tracked for 181 ± 56 days. Within the 16 deaths in follow-up time, 6 sudden cardiac deaths was documented. Cox regression, defined QTc as the predictor of all-cause and sudden death mortality (all-cause: HR 1.041, 95% CI 1.015-1.067, P=0.002; sudden death: HR 1.063, 95% CI 1.023-1.105, P=0.002); nevertheless, efforts to demonstrate QT dispersion as the predictor failed. Conclusion: The predictive nature of QT parameters was significant after modification of the variables; therefore, they should be measured for risk stratification of ventricular repolarization arrhythmia and death in decompensated heart failure patients.
Keywords: Prognostic value, QT parameters, Decompensated heart failure, ventricular systolic dysfunction
Type of Study: Original Article | Subject: Cardiology
Received: 2021/03/22 | Accepted: 2021/08/22
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Caspian Journal of Internal Medicine
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