Dataset Information

T_peak-T_end, T_peak-T_end/QT ratio and T_peak-T_end dispersion for risk stratification in Brugada Syndrome: A systematic review and meta-analysis.

ABSTRACT:

Background

Brugada syndrome is an ion channelopathy that predisposes affected subjects to ventricular tachycardia/fibrillation (VT/VF), potentially leading to sudden cardiac death (SCD). T_peak-T_end intervals, (T_peak-T_end)/QT ratio and T_peak-T_end dispersion have been proposed for risk stratification, but their predictive values in Brugada syndrome have been challenged recently.

Methods

A systematic review and meta-analysis was conducted to examine their values in predicting arrhythmic and mortality outcomes in Brugada Syndrome. PubMed and Embase databases were searched until 1 May 2018, identifying 29 and 57 studies.

Results

Nine studies involving 1740 subjects (mean age 45 years old, 80% male, mean follow-up duration was 68 ± 27 months) were included. The mean T_peak-T_end interval was 98.9 ms (95% CI: 90.5-107.2 ms) for patients with adverse events (ventricular arrhythmias or SCD) compared to 87.7 ms (95% CI: 80.5-94.9 ms) for those without such events, with a mean difference of 11.9 ms (95% CI: 3.6-20.2 ms, P = 0.005; I ² = 86%). Higher (T_peak-T_end)/QT ratios (mean difference = 0.019, 95% CI: 0.003-0.036, P = 0.024; I ² = 74%) and T_peak-T_end dispersion (mean difference = 7.8 ms, 95% CI: 2.1-13.4 ms, P = 0.007; I ² = 80%) were observed for the event-positive group.

Conclusion

T_peak-T_end interval, (T_peak-T_end)/QT ratio and T_peak-T_end dispersion were higher in high-risk than low-risk Brugada subjects, and thus offer incremental value for risk stratification.

SUBMITTER: Tse G

PROVIDER: S-EPMC6288557 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Publications

Tpeak-Tend, Tpeak-Tend/QT ratio and Tpeak-Tend dispersion for risk stratification in Brugada Syndrome: A systematic review and meta-analysis.

Tse Gary G Gong Mengqi M Li Christien Ka Hou CKH Leung Keith Sai Kit KSK Georgopoulos Stamatis S Bazoukis George G Letsas Konstantinos P KP Sawant Abhishek C AC Mugnai Giacomo G Wong Martin C S MCS Yan Gan Xin GX Brugada Pedro P Chierchia Gian-Battista GB de Asmundis Carlo C Baranchuk Adrian A Liu Tong T

Journal of arrhythmia 20180910 6

<h4>Background</h4>Brugada syndrome is an ion channelopathy that predisposes affected subjects to ventricular tachycardia/fibrillation (VT/VF), potentially leading to sudden cardiac death (SCD). Tpeak-Tend intervals, (Tpeak-Tend)/QT ratio and Tpeak-Tend dispersion have been proposed for risk stratification, but their predictive values in Brugada syndrome have been challenged recently.<h4>Methods</h4>A systematic review and meta-an ...[more]

PMID: 30555602

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Project description:Background A combination of clinical and electrocardiographic risk factors is used for risk stratification in Brugada syndrome. In this study, we tested the hypothesis that the incorporation of latent variables between variables using nonnegative matrix factorization can improve risk stratification compared with logistic regression. Methods and Results This was a retrospective cohort study of patients presented with Brugada electrocardiographic patterns between 2000 and 2016 from Hong Kong, China. The primary outcome was spontaneous ventricular tachycardia/ventricular fibrillation. The external validation cohort included patients from 3 countries. A total of 149 patients with Brugada syndrome (84% males, median age of presentation 50 [38-61] years) were included. Compared with the nonarrhythmic group (n=117, 79%), the spontaneous ventricular tachycardia/ ventricular fibrillation group (n=32, 21%) were more likely to suffer from syncope (69% versus 37%, P=0.001) and atrial fibrillation (16% versus 4%, P=0.023) as well as displayed longer QTc intervals (424 [399-449] versus 408 [386-425]; P=0.020). No difference in QRS interval was observed (108 [98-114] versus 102 [95-110], P=0.104). Logistic regression found that syncope (odds ratio, 3.79; 95% CI, 1.64-8.74; P=0.002), atrial fibrillation (odds ratio, 4.15; 95% CI, 1.12-15.36; P=0.033), QRS duration (odds ratio, 1.03; 95% CI, 1.002-1.06; P=0.037) and QTc interval (odds ratio, 1.02; 95% CI, 1.01-1.03; P=0.009) were significant predictors of spontaneous ventricular tachycardia/ventricular fibrillation. Increasing the number of latent variables of these electrocardiographic indices incorporated from n=0 (logistic regression) to n=6 by nonnegative matrix factorization improved the area under the curve of the receiving operating characteristics curve from 0.71 to 0.80. The model improves area under the curve of external validation cohort (n=227) from 0.64 to 0.71. Conclusions Nonnegative matrix factorization improves the predictive performance of arrhythmic outcomes by extracting latent features between different variables.