Myocardial electrical instability score: clinical and prognostic significance
Aim. To develop and test a risk-stratification model for patients with coronary artery disease (CAD) and non-ischemic pathologies based on a computer analysis of electrical instability ECG markers.Material and methods. In the period from 2011 to 2018, the study included 1014 patients with CAD and no...
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«FIRMA «SILICEA» LLC
2019-12-01
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| Series: | Российский кардиологический журнал |
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| Online Access: | https://russjcardiol.elpub.ru/jour/article/view/3468 |
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| author | A. V. Frolov T. G. Vaykhanskaya O. P. Melnikova A. P. Vorobev A. G. Mrochek |
| author_facet | A. V. Frolov T. G. Vaykhanskaya O. P. Melnikova A. P. Vorobev A. G. Mrochek |
| author_sort | A. V. Frolov |
| collection | DOAJ |
| description | Aim. To develop and test a risk-stratification model for patients with coronary artery disease (CAD) and non-ischemic pathologies based on a computer analysis of electrical instability ECG markers.Material and methods. In the period from 2011 to 2018, the study included 1014 patients with CAD and non-ischemic pathologies. Depending on ventricular arrhythmia status, the analyzed cohort was divided into 3 groups: 1) 644 patients without lifethreatening ventricular tachyarrhythmias (-VTA), mean age 51,7±16,1 years; 2) 280 patients with clinically significant ventricular arrhythmias (+csVA): ventricular extrasystoles (VES) >1500/24 h, coupled VES >50/24 h or unstable ventricular tachycardia (uVT), mean age 46,7±14,0 years; 3) 90 patients with life-threatening ventricular tachyarrhythmias (+VTA): persistent VT (pVT), successful cardiopulmonary resuscitation (CPR), appropriate discharges by implanted cardioverter defibrillator (CVD), sudden cardiac death (SCD), mean age 46,8±12,7 years.Using the Intekard 7.3 software, ECG markers of myocardial electrical instability were analyzed: T wave alternation, QT interval and dispersion, fragmented QRS, spatial QRS-T angle, turbulence onset and slope, and heart rate deceleration/acceleration.Results. Statistically significant differences were found between the values of T wave alternation, QT interval, fragmented QRS and QRS-T angle in groups 1 and 3 (-VTA) and (+VTA), p<0,005.Personalized model was formed for predicting the risk of life-threatening VTA (primary endpoints: pVT, appropriate CVD discharges, CPR, SCD) in patients with CAD and non-ischemic pathologies (cardiomyopathy, channelopathy) in 5 years follow-up. Integral score of myocardial electrical instability is proposed as new quantitative parameter for risk stratification (sensitivity 75%, specificity 78%, accuracy 77%).Conclusion. The myocardial electrical instability score provides the individual assessment of the dynamic SCD risk. The Intekard 7.3 software is a simple, economic and accessible ECG tool for arrhythmia monitoring. |
| format | Article |
| id | doaj-art-388039e1f2944018a9d0257956fafd89 |
| institution | DOAJ |
| issn | 1560-4071 2618-7620 |
| language | Russian |
| publishDate | 2019-12-01 |
| publisher | «FIRMA «SILICEA» LLC |
| record_format | Article |
| series | Российский кардиологический журнал |
| spelling | doaj-art-388039e1f2944018a9d0257956fafd892025-08-20T02:59:07Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202019-12-01012556110.15829/1560-4071-2019-12-55-612761Myocardial electrical instability score: clinical and prognostic significanceA. V. Frolov0T. G. Vaykhanskaya1O. P. Melnikova2A. P. Vorobev3A. G. Mrochek4Republican Scientific and Practical Center “Cardiology”Republican Scientific and Practical Center “Cardiology”Republican Scientific and Practical Center “Cardiology”Republican Scientific and Practical Center “Cardiology”Republican Scientific and Practical Center “Cardiology”Aim. To develop and test a risk-stratification model for patients with coronary artery disease (CAD) and non-ischemic pathologies based on a computer analysis of electrical instability ECG markers.Material and methods. In the period from 2011 to 2018, the study included 1014 patients with CAD and non-ischemic pathologies. Depending on ventricular arrhythmia status, the analyzed cohort was divided into 3 groups: 1) 644 patients without lifethreatening ventricular tachyarrhythmias (-VTA), mean age 51,7±16,1 years; 2) 280 patients with clinically significant ventricular arrhythmias (+csVA): ventricular extrasystoles (VES) >1500/24 h, coupled VES >50/24 h or unstable ventricular tachycardia (uVT), mean age 46,7±14,0 years; 3) 90 patients with life-threatening ventricular tachyarrhythmias (+VTA): persistent VT (pVT), successful cardiopulmonary resuscitation (CPR), appropriate discharges by implanted cardioverter defibrillator (CVD), sudden cardiac death (SCD), mean age 46,8±12,7 years.Using the Intekard 7.3 software, ECG markers of myocardial electrical instability were analyzed: T wave alternation, QT interval and dispersion, fragmented QRS, spatial QRS-T angle, turbulence onset and slope, and heart rate deceleration/acceleration.Results. Statistically significant differences were found between the values of T wave alternation, QT interval, fragmented QRS and QRS-T angle in groups 1 and 3 (-VTA) and (+VTA), p<0,005.Personalized model was formed for predicting the risk of life-threatening VTA (primary endpoints: pVT, appropriate CVD discharges, CPR, SCD) in patients with CAD and non-ischemic pathologies (cardiomyopathy, channelopathy) in 5 years follow-up. Integral score of myocardial electrical instability is proposed as new quantitative parameter for risk stratification (sensitivity 75%, specificity 78%, accuracy 77%).Conclusion. The myocardial electrical instability score provides the individual assessment of the dynamic SCD risk. The Intekard 7.3 software is a simple, economic and accessible ECG tool for arrhythmia monitoring.https://russjcardiol.elpub.ru/jour/article/view/3468sudden cardiac deathventricular tachycardiaprognosiselectrical myocardial instabilityelectrocardiography |
| spellingShingle | A. V. Frolov T. G. Vaykhanskaya O. P. Melnikova A. P. Vorobev A. G. Mrochek Myocardial electrical instability score: clinical and prognostic significance Российский кардиологический журнал sudden cardiac death ventricular tachycardia prognosis electrical myocardial instability electrocardiography |
| title | Myocardial electrical instability score: clinical and prognostic significance |
| title_full | Myocardial electrical instability score: clinical and prognostic significance |
| title_fullStr | Myocardial electrical instability score: clinical and prognostic significance |
| title_full_unstemmed | Myocardial electrical instability score: clinical and prognostic significance |
| title_short | Myocardial electrical instability score: clinical and prognostic significance |
| title_sort | myocardial electrical instability score clinical and prognostic significance |
| topic | sudden cardiac death ventricular tachycardia prognosis electrical myocardial instability electrocardiography |
| url | https://russjcardiol.elpub.ru/jour/article/view/3468 |
| work_keys_str_mv | AT avfrolov myocardialelectricalinstabilityscoreclinicalandprognosticsignificance AT tgvaykhanskaya myocardialelectricalinstabilityscoreclinicalandprognosticsignificance AT opmelnikova myocardialelectricalinstabilityscoreclinicalandprognosticsignificance AT apvorobev myocardialelectricalinstabilityscoreclinicalandprognosticsignificance AT agmrochek myocardialelectricalinstabilityscoreclinicalandprognosticsignificance |