Background/aim

Heart failure is a leading cause of morbidity and mortality worldwide and it is a major cause of emergency department access for cardiovascular disease patients. Aim of this study was to identify the electrocardiographic (ECG) markers, based on short-term temporal repolarization dispersion, capable to individuate decompensated chronic heart failure (CHF) patients at high mortality risk.

Methods

We obtained the following variables from an ECG recording, monitored via mobile phone, during 5-minute recordings in decompensated CHF patients: RR, QT end (QTe), QT peak (QTp) and T peak to T end (Te) and we calculated mean, standard deviation (_SD) and normalized index (N).

Results

In-hospital mortality occurred for 25 subjects on 101 studied (25%). Deceased patients showed higher QTe_SD (p < 0.01), Te mean (p < 0.01), Te_SD (p < 0.05), QTeVN (p < 0.05) than the surviving group. Logistic multivariable analysis evidenced that Te mean was a significant predictor of in-hospital mortality (odd ratio: 0.09, 95% confidence limit: 0.02–0.35, p: 0.001). At multiple regression analysis, Te_SD was significantly and positively related only to the NT-pro BNP levels (r: 0.540; p < 0.001). The Te mean (AUC: 0.677 p < 0.01) and Te_SD (AUC: 0.647, p: 0.05) showed significant sensitivity/specificity for the event.

Conclusions

The Te mean and Te_SD seem to be a promising noninvasive clinical marker able to identify patients with decompensated CHF at high risk of in-hospital mortality.

中文翻译：

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代偿性心力衰竭的医院死亡率。初步研究。

背景/目的

心力衰竭是全球发病率和死亡率的主要原因，也是心血管疾病患者急诊就诊的主要原因。这项研究的目的是确定基于短期时间复极分散的心电图（ECG）标记，能够区分高死亡率风险下的失代偿性慢性心力衰竭（CHF）患者。

方法

在失代偿的CHF患者的5分钟录音过程中，我们通过移动电话监控的ECG录音获得以下变量：RR，QT终点（QTe），QT峰（QTp）和T峰至T终点（Te），并进行了计算均值，标准差（_SD）和归一化指数（N）。

结果

在101位研究对象中，有25位受试者发生了院内死亡率（25％）。死亡患者的QTe _SD（p <0.01），Te平均值（p <0.01），Te _SD（p <0.05），QTeVN（p <0.05）均高于存活组。逻辑多变量分析表明，Te均值是院内死亡率的重要预测指标（比值：0.09，95％置信区间：0.02-0.35，p：0.001）。在多元回归分析中，Te _SD仅与NT-pro BNP水平显着正相关（r：0.540； p <0.001）。Te平均值（AUC：0.677 p <0.01）和Te _SD（AUC：0.647，p：0.05）对事件显示出显着的敏感性/特异性。

结论

Te mean和Te _SD似乎是一种有前途的无创临床标记，能够识别出院内死亡风险高的代偿性CHF患者。