Matches in SemOpenAlex for { <https://semopenalex.org/work/W1975690492> ?p ?o ?g. }
Showing items 1 to 92 of
92
with 100 items per page.
- W1975690492 endingPage "iii3" @default.
- W1975690492 startingPage "iii3" @default.
- W1975690492 abstract "Introduction: Sudden cardiac death (SCD) risk prediction has substantial limitations. The Regional Restitution Instability Index (R2I2) is a promising new ECG-based biomarker of SCD. R2I2 uses the surface 12-lead ECG to quantify regional heterogeneity of electrical restitution, a property of ventricular myocardium implicated in arrhythmogenesis. We investigated the potential of a combined R2I2 and amino-terminal pro-B-type natriuretic peptide (NT-proBNP) SCD risk marker in an ischaemic cardiomyopathy cohort.Methods: Blinded, prospective, observational study of 55 ischaemic cardiomyopathy patients (age: 67±9years, ejection fraction: 31±10%) undergoing risk stratification for an implantable cardioverter defibrillator (ICD). R2I2 was calculated using a pre-defined technique: an electrophysiology study is performed and ECG surrogates for action potential duration (QRS-onset to T-peak) and diastolic interval (T-peak to QRS-onset) are used to measure heterogeneity of electrical restitution. Plasma samples obtained on the day of the ICD procedure were assayed for NT-proBNP. A pre-defined R2I2 cut-off (1.03) was combined with an optimal log NT-proBNP cut-off (2.65) to investigate the potential of a combined risk marker.Results: During median follow up of 22 months, 15 patients experienced ventricular arrhythmia (VA)/SCD. R2I2 was significantly higher in patients experiencing VA/SCD than those not (mean±SEM:1.12±0.05 vs 0.84±0.09, p=0.004). R2I2 was independent of age, gender, left ventricular ejection fraction, QRS duration and log NT-proBNP in prediction of endpoint (Cox model, p=0.002). Partitioning patients using a log NT-proBNP ≥ 2.65 gave a significantly higher rate of VA/SCD in those with high versus low log NT-proBNP (38% vs. 6%, p=0.01). Patients with R2I2 ≥ 1.03 and log NT-proBNP ≥ 2.65 had a hazard ratio for VA/SCD 17.2 times that of patients negative for both (Cox model, p=0.007). Kaplan Meier analysis (Figure 1) showed significant separation in rates of VA/SCD in patients stratified by R2I2 ≥ 1.03 and log NT-proBNP ≥ 2.65 (log-rank, p<0.0001).Conclusion: A combined R2I2 + NT-proBNP risk marker identifies patients at particularly high risk of ventricular arrhythmia/SCD. These patients might benefit from careful treatment optimisation. R2I2 + NT-proBNP might retain sufficient positive predictive value for application to lower risk cohorts.![Graphic][1] Figure 1 Kaplan-Meier curves illustrating rates of VA/SCD in patients stratified using R212 and NT-proBNP [1]: /embed/inline-graphic-1.gif" @default.
- W1975690492 created "2016-06-24" @default.
- W1975690492 creator A5001748030 @default.
- W1975690492 creator A5003459019 @default.
- W1975690492 creator A5007668772 @default.
- W1975690492 creator A5009101023 @default.
- W1975690492 creator A5017924749 @default.
- W1975690492 creator A5022030639 @default.
- W1975690492 creator A5028012025 @default.
- W1975690492 creator A5031689367 @default.
- W1975690492 creator A5064878242 @default.
- W1975690492 creator A5079180741 @default.
- W1975690492 date "2014-10-01" @default.
- W1975690492 modified "2023-09-23" @default.
- W1975690492 title "5Improving sudden cardiac death risk stratification in patients with ischaemic cardiomyopathy: a combined electrocardiogram and plasma biomarker approach" @default.
- W1975690492 doi "https://doi.org/10.1093/europace/euu236.5" @default.
- W1975690492 hasPublicationYear "2014" @default.
- W1975690492 type Work @default.
- W1975690492 sameAs 1975690492 @default.
- W1975690492 citedByCount "0" @default.
- W1975690492 crossrefType "journal-article" @default.
- W1975690492 hasAuthorship W1975690492A5001748030 @default.
- W1975690492 hasAuthorship W1975690492A5003459019 @default.
- W1975690492 hasAuthorship W1975690492A5007668772 @default.
- W1975690492 hasAuthorship W1975690492A5009101023 @default.
- W1975690492 hasAuthorship W1975690492A5017924749 @default.
- W1975690492 hasAuthorship W1975690492A5022030639 @default.
- W1975690492 hasAuthorship W1975690492A5028012025 @default.
- W1975690492 hasAuthorship W1975690492A5031689367 @default.
- W1975690492 hasAuthorship W1975690492A5064878242 @default.
- W1975690492 hasAuthorship W1975690492A5079180741 @default.
- W1975690492 hasBestOaLocation W19756904921 @default.
- W1975690492 hasConcept C111773187 @default.
- W1975690492 hasConcept C126322002 @default.
- W1975690492 hasConcept C164705383 @default.
- W1975690492 hasConcept C185592680 @default.
- W1975690492 hasConcept C188816634 @default.
- W1975690492 hasConcept C2775915353 @default.
- W1975690492 hasConcept C2775935837 @default.
- W1975690492 hasConcept C2777093960 @default.
- W1975690492 hasConcept C2778198053 @default.
- W1975690492 hasConcept C2778797674 @default.
- W1975690492 hasConcept C2781197716 @default.
- W1975690492 hasConcept C55493867 @default.
- W1975690492 hasConcept C71924100 @default.
- W1975690492 hasConcept C78085059 @default.
- W1975690492 hasConceptScore W1975690492C111773187 @default.
- W1975690492 hasConceptScore W1975690492C126322002 @default.
- W1975690492 hasConceptScore W1975690492C164705383 @default.
- W1975690492 hasConceptScore W1975690492C185592680 @default.
- W1975690492 hasConceptScore W1975690492C188816634 @default.
- W1975690492 hasConceptScore W1975690492C2775915353 @default.
- W1975690492 hasConceptScore W1975690492C2775935837 @default.
- W1975690492 hasConceptScore W1975690492C2777093960 @default.
- W1975690492 hasConceptScore W1975690492C2778198053 @default.
- W1975690492 hasConceptScore W1975690492C2778797674 @default.
- W1975690492 hasConceptScore W1975690492C2781197716 @default.
- W1975690492 hasConceptScore W1975690492C55493867 @default.
- W1975690492 hasConceptScore W1975690492C71924100 @default.
- W1975690492 hasConceptScore W1975690492C78085059 @default.
- W1975690492 hasIssue "suppl_3" @default.
- W1975690492 hasLocation W19756904921 @default.
- W1975690492 hasLocation W19756904922 @default.
- W1975690492 hasOpenAccess W1975690492 @default.
- W1975690492 hasPrimaryLocation W19756904921 @default.
- W1975690492 hasRelatedWork W100468201 @default.
- W1975690492 hasRelatedWork W1991013266 @default.
- W1975690492 hasRelatedWork W2011370424 @default.
- W1975690492 hasRelatedWork W2061364967 @default.
- W1975690492 hasRelatedWork W2084451248 @default.
- W1975690492 hasRelatedWork W2097776216 @default.
- W1975690492 hasRelatedWork W2104174124 @default.
- W1975690492 hasRelatedWork W2149699202 @default.
- W1975690492 hasRelatedWork W2155469967 @default.
- W1975690492 hasRelatedWork W2208343980 @default.
- W1975690492 hasRelatedWork W2328890925 @default.
- W1975690492 hasRelatedWork W2397045396 @default.
- W1975690492 hasRelatedWork W2509272523 @default.
- W1975690492 hasRelatedWork W2593643672 @default.
- W1975690492 hasRelatedWork W2945887721 @default.
- W1975690492 hasRelatedWork W2959974431 @default.
- W1975690492 hasRelatedWork W3029570719 @default.
- W1975690492 hasRelatedWork W3128574033 @default.
- W1975690492 hasRelatedWork W3196969140 @default.
- W1975690492 hasRelatedWork W651145527 @default.
- W1975690492 hasVolume "16" @default.
- W1975690492 isParatext "false" @default.
- W1975690492 isRetracted "false" @default.
- W1975690492 magId "1975690492" @default.
- W1975690492 workType "article" @default.
!["Introduction: Sudden cardiac death (SCD) risk prediction has substantial limitations. The Regional Restitution Instability Index (R2I2) is a promising new ECG-based biomarker of SCD. R2I2 uses the surface 12-lead ECG to quantify regional heterogeneity of electrical restitution, a property of ventricular myocardium implicated in arrhythmogenesis. We investigated the potential of a combined R2I2 and amino-terminal pro-B-type natriuretic peptide (NT-proBNP) SCD risk marker in an ischaemic cardiomyopathy cohort.Methods: Blinded, prospective, observational study of 55 ischaemic cardiomyopathy patients (age: 67±9years, ejection fraction: 31±10%) undergoing risk stratification for an implantable cardioverter defibrillator (ICD). R2I2 was calculated using a pre-defined technique: an electrophysiology study is performed and ECG surrogates for action potential duration (QRS-onset to T-peak) and diastolic interval (T-peak to QRS-onset) are used to measure heterogeneity of electrical restitution. Plasma samples obtained on the day of the ICD procedure were assayed for NT-proBNP. A pre-defined R2I2 cut-off (1.03) was combined with an optimal log NT-proBNP cut-off (2.65) to investigate the potential of a combined risk marker.Results: During median follow up of 22 months, 15 patients experienced ventricular arrhythmia (VA)/SCD. R2I2 was significantly higher in patients experiencing VA/SCD than those not (mean±SEM:1.12±0.05 vs 0.84±0.09, p=0.004). R2I2 was independent of age, gender, left ventricular ejection fraction, QRS duration and log NT-proBNP in prediction of endpoint (Cox model, p=0.002). Partitioning patients using a log NT-proBNP ≥ 2.65 gave a significantly higher rate of VA/SCD in those with high versus low log NT-proBNP (38% vs. 6%, p=0.01). Patients with R2I2 ≥ 1.03 and log NT-proBNP ≥ 2.65 had a hazard ratio for VA/SCD 17.2 times that of patients negative for both (Cox model, p=0.007). Kaplan Meier analysis (Figure 1) showed significant separation in rates of VA/SCD in patients stratified by R2I2 ≥ 1.03 and log NT-proBNP ≥ 2.65 (log-rank, p<0.0001).Conclusion: A combined R2I2 + NT-proBNP risk marker identifies patients at particularly high risk of ventricular arrhythmia/SCD. These patients might benefit from careful treatment optimisation. R2I2 + NT-proBNP might retain sufficient positive predictive value for application to lower risk cohorts.![Graphic][1] Figure 1 Kaplan-Meier curves illustrating rates of VA/SCD in patients stratified using R212 and NT-proBNP [1]: /embed/inline-graphic-1.gif"](?object=%22Introduction%3A%20Sudden%20cardiac%20death%20(SCD)%20risk%20prediction%20has%20substantial%20limitations.%20The%20Regional%20Restitution%20Instability%20Index%20(R2I2)%20is%20a%20promising%20new%20ECG-based%20biomarker%20of%20SCD.%20R2I2%20uses%20the%20surface%2012-lead%20ECG%20to%20quantify%20regional%20heterogeneity%20of%20electrical%20restitution%2C%20a%20property%20of%20ventricular%20myocardium%20implicated%20in%20arrhythmogenesis.%20We%20investigated%20the%20potential%20of%20a%20combined%20R2I2%20and%20amino-terminal%20pro-B-type%20natriuretic%20peptide%20(NT-proBNP)%20SCD%20risk%20marker%20in%20an%20ischaemic%20cardiomyopathy%20cohort.Methods%3A%20Blinded%2C%20prospective%2C%20observational%20study%20of%2055%20ischaemic%20cardiomyopathy%20patients%20(age%3A%2067%C2%B19years%2C%20ejection%20fraction%3A%2031%C2%B110%25)%20undergoing%20risk%20stratification%20for%20an%20implantable%20cardioverter%20defibrillator%20(ICD).%20R2I2%20was%20calculated%20using%20a%20pre-defined%20technique%3A%20an%20electrophysiology%20study%20is%20performed%20and%20ECG%20surrogates%20for%20action%20potential%20duration%20(QRS-onset%20to%20T-peak)%20and%20diastolic%20interval%20(T-peak%20to%20QRS-onset)%20are%20used%20to%20measure%20heterogeneity%20of%20electrical%20restitution.%20Plasma%20samples%20obtained%20on%20the%20day%20of%20the%20ICD%20procedure%20were%20assayed%20for%20NT-proBNP.%20A%20pre-defined%20R2I2%20cut-off%20(1.03)%20was%20combined%20with%20an%20optimal%20log%20NT-proBNP%20cut-off%20(2.65)%20to%20investigate%20the%20potential%20of%20a%20combined%20risk%20marker.Results%3A%20During%20median%20follow%20up%20of%2022%20months%2C%2015%20patients%20experienced%20ventricular%20arrhythmia%20(VA)%2FSCD.%20R2I2%20was%20significantly%20higher%20in%20patients%20experiencing%20VA%2FSCD%20than%20those%20not%20(mean%C2%B1SEM%3A1.12%C2%B10.05%20vs%200.84%C2%B10.09%2C%20p%3D0.004).%20R2I2%20was%20independent%20of%20age%2C%20gender%2C%20left%20ventricular%20ejection%20fraction%2C%20QRS%20duration%20and%20log%20NT-proBNP%20in%20prediction%20of%20endpoint%20(Cox%20model%2C%20p%3D0.002).%20Partitioning%20patients%20using%20a%20log%20NT-proBNP%20%E2%89%A5%202.65%20gave%20a%20significantly%20higher%20rate%20of%20VA%2FSCD%20in%20those%20with%20high%20versus%20low%20log%20NT-proBNP%20(38%25%20vs.%206%25%2C%20p%3D0.01).%20Patients%20with%20R2I2%20%E2%89%A5%201.03%20and%20log%20NT-proBNP%20%E2%89%A5%202.65%20had%20a%20hazard%20ratio%20for%20VA%2FSCD%2017.2%20times%20that%20of%20patients%20negative%20for%20both%20(Cox%20model%2C%20p%3D0.007).%20Kaplan%20Meier%20analysis%20(Figure%C2%A01)%20showed%20significant%20separation%20in%20rates%20of%20VA%2FSCD%20in%20patients%20stratified%20by%20R2I2%20%E2%89%A5%201.03%20and%20log%20NT-proBNP%20%E2%89%A5%202.65%20(log-rank%2C%20p%3C0.0001).Conclusion%3A%20A%20combined%20R2I2%20%2B%20NT-proBNP%20risk%20marker%20identifies%20patients%20at%20particularly%20high%20risk%20of%20ventricular%20arrhythmia%2FSCD.%20These%20patients%20might%20benefit%20from%20careful%20treatment%20optimisation.%20R2I2%20%2B%20NT-proBNP%20might%20retain%20sufficient%20positive%20predictive%20value%20for%20application%20to%20lower%20risk%20cohorts.!%5BGraphic%5D%5B1%5D%20Figure%201%20Kaplan-Meier%20curves%20illustrating%20rates%20of%20VA%2FSCD%20in%20patients%20stratified%20using%20R212%20and%20NT-proBNP%20%5B1%5D%3A%20%2Fembed%2Finline-graphic-1.gif%22){kind=link}