Temporal changes of noninvasive electrocardiographic risk factors for sudden cardiac death in post‐myocardial infarction patients with preserved ejection fraction: Insights from the PRESERVE‐EF study. Issue 1 (12th October 2019)

• Record Type: Journal Article
• Authors: Xenogiannis, Iosif; Gatzoulis, Konstantinos A.; Flevari, Panagiota; Ikonomidis, Ignatios; Iliodromitis, Efstathios; Trachanas, Konstantinos; Vlachos, Konstantinos; Arsenos, Petros; Tsiachris, Dimitrios; Tousoulis, Dimitrios; Brilakis, Emmanouil S.; Alexopoulos, Dimitrios
• Is Part Of: Annals of noninvasive electrocardiology. Volume 25:Issue 1(2020:Jan.)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-10-12
• Subjects: myocardial infarction -- noninvasive risk factors -- preserved EF -- sudden cardiac death; Electrocardiography -- Periodicals; Arrhythmia -- Periodicals; 616.1207547
• DOI: 10.1111/anec.12701
• Languages: English
• ISSNs: 1082-720X

Abstract

Abstract: Background: Several noninvasive risk factors (NIRFs) have been proposed for sudden cardiac death risk stratification in post‐myocardial infarction (post‐MI) patients with preserved ejection fraction (EF). However, it remains unclear if these factors change over time. Methods: We evaluated seven electrocardiographic NIRFs as they were described in the PRESERVE‐EF trial in 80 post‐MI patients with EF ≥ 40%, at least 40 days after revascularization and 1 year later. Results: Mean patient age was 56 ± 10 years, and 88% were men. Mean EF was 50 ± 5%. The prevalence of (a) positive late potentials (27.5% vs. 28.8%, p = .860), (b) >30 premature ventricular complexes/hour (8.8% vs. 11.3%, p = .598), (c) nonsustained ventricular tachycardia (8.8% vs. 5%, p = .349), (d) standard deviation of normal RR intervals <75 ms (3.8% vs. 3.8%, p = 1.000), (e) QTc derived from 24‐hr electrocardiography >440 ms (men) or >450 ms (women) (17.5% vs. 17.5%, p = 1.000), (f) deceleration capacity ≤4.5 ms and heart rate turbulence onset ≥0% and slope ≤2.5 ms (2.5% vs. 3.8%. p = 1.000), and (g) ambulatory T‐wave alternans ≥65 μV in two Holter channels (6.3% vs. 6.3%, p = 1.000) were similar between the two measurements. However, five patients (6.3%) without any NIRFs during the first assessment had at least one positive NIRF at the second assessment and six patients (7.5%) with at least one NIRF at baseline had no positive NIRFs at 1 year. Conclusions: While the prevalence of the examined electrocardiographic NIRFs between the two examinations was similar on a population basis, some patients without NIRFs at baseline developed NIRFs at 1 year and vice versa, highlighting the need for risk factor reassessment during follow‐up.