Prognostic significance of T-wave amplitude in lead aVR in heart failure patients with narrow QRS complexes

Kentarou Okuda, Eiichi Watanabe, Kan Sano, Tomoharu Arakawa, Mayumi Yamamoto, Yoshihiro Sobue, Tatsushi Uchiyama, Yukio Ozaki

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Abstract

Background: Prolonged duration of the QRS complex is a prognostic marker in patients with heart failure (HF), whereas electrocadiographic markers in HF with narrow QRS complex remain unclear. We evaluated the prognostic value of the T-wave amplitude in lead aVR in HF patients with narrow QRS complexes. Methods: We examined 331 patients who were admitted to our hospital for worsening HF (68 ± 15 years, mean ± standard deviation) from January 2000 to October 2004 who had sinus rhythm and QRS complex <120 ms. The patients were categorized into three groups according to the peak T-wave amplitude from baseline in lead aVR: negative (<-0.1 mV; n = 209, 63%), flat (-0.1-0.1 mV; n = 64, 19%), and positive (>0.1 mV; n = 58, 18%). Results: During a mean follow-up of 33 months, 113 (34%) patients had all-cause death, the primary end point. After adjusting for clinical covariates, flat T wave (hazard ratio [HR] 1.86, 95% confidence interval [CI] 1.42-2.46), and positive T wave (HR 6.76, 95% CI 3.92-11.8) were independent predictors of mortality, when negative T wave was considered a reference. Conclusions: As the peak T-wave amplitude in lead aVR becomes less negative, there was a progressive increase in mortality. The T wave in lead aVR provides prognostic information for risk stratification in HF patients with narrow QRS complexes.

Original languageEnglish
Pages (from-to)250-257
Number of pages8
JournalAnnals of Noninvasive Electrocardiology
Volume16
Issue number3
DOIs
Publication statusPublished - 01-07-2011

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Heart Failure
Confidence Intervals
Mortality
Cause of Death
Lead

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Okuda, Kentarou ; Watanabe, Eiichi ; Sano, Kan ; Arakawa, Tomoharu ; Yamamoto, Mayumi ; Sobue, Yoshihiro ; Uchiyama, Tatsushi ; Ozaki, Yukio. / Prognostic significance of T-wave amplitude in lead aVR in heart failure patients with narrow QRS complexes. In: Annals of Noninvasive Electrocardiology. 2011 ; Vol. 16, No. 3. pp. 250-257.
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Prognostic significance of T-wave amplitude in lead aVR in heart failure patients with narrow QRS complexes. / Okuda, Kentarou; Watanabe, Eiichi; Sano, Kan; Arakawa, Tomoharu; Yamamoto, Mayumi; Sobue, Yoshihiro; Uchiyama, Tatsushi; Ozaki, Yukio.

In: Annals of Noninvasive Electrocardiology, Vol. 16, No. 3, 01.07.2011, p. 250-257.

Research output: Contribution to journalArticle

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T1 - Prognostic significance of T-wave amplitude in lead aVR in heart failure patients with narrow QRS complexes

AU - Okuda, Kentarou

AU - Watanabe, Eiichi

AU - Sano, Kan

AU - Arakawa, Tomoharu

AU - Yamamoto, Mayumi

AU - Sobue, Yoshihiro

AU - Uchiyama, Tatsushi

AU - Ozaki, Yukio

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N2 - Background: Prolonged duration of the QRS complex is a prognostic marker in patients with heart failure (HF), whereas electrocadiographic markers in HF with narrow QRS complex remain unclear. We evaluated the prognostic value of the T-wave amplitude in lead aVR in HF patients with narrow QRS complexes. Methods: We examined 331 patients who were admitted to our hospital for worsening HF (68 ± 15 years, mean ± standard deviation) from January 2000 to October 2004 who had sinus rhythm and QRS complex <120 ms. The patients were categorized into three groups according to the peak T-wave amplitude from baseline in lead aVR: negative (<-0.1 mV; n = 209, 63%), flat (-0.1-0.1 mV; n = 64, 19%), and positive (>0.1 mV; n = 58, 18%). Results: During a mean follow-up of 33 months, 113 (34%) patients had all-cause death, the primary end point. After adjusting for clinical covariates, flat T wave (hazard ratio [HR] 1.86, 95% confidence interval [CI] 1.42-2.46), and positive T wave (HR 6.76, 95% CI 3.92-11.8) were independent predictors of mortality, when negative T wave was considered a reference. Conclusions: As the peak T-wave amplitude in lead aVR becomes less negative, there was a progressive increase in mortality. The T wave in lead aVR provides prognostic information for risk stratification in HF patients with narrow QRS complexes.

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