The Tpeak – Tend interval as an electrocardiographic risk marker of arrhythmic and mortality outcomes: a systematic review and meta-analysis

Tse, Gary, Gong, Mengqi, Wong, Wing Tak, Georgopoulos, Stamatis, Letsas, Konstantinos P., Vassiliou, Vassilios S. ORCID:, Chan, Yat Sun, Yan, Bryan P., Wong, Sunny Hei, Wu, William K. K., Ciobanu, Ana, Li, Guangping, Shenthar, Jayaprakash, Saguner, Ardan M., Ali-Hasan-Al-Saegh, Sadeq, Bhardwaj, Aishwarya, Sawant, Abhishek C., Whittaker, Paula, Xia, Yunlong, Yan, Gan-Xin and Liu, Tong (2017) The Tpeak – Tend interval as an electrocardiographic risk marker of arrhythmic and mortality outcomes: a systematic review and meta-analysis. Heart Rhythm, 14 (8). pp. 1131-1137. ISSN 1547-5271

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Background: The Tpeak – Tend interval, an electrocardiographic marker reflecting transmural dispersion of repolarization, has been used to predict ventricular tachycardia/fibrillation (VT/VF) and sudden cardiac death (SCD) in different clinical settings. Objective: This systematic review and meta-analysis evaluated the significance of Tpeak – Tend interval in predicting arrhythmic and/or mortality endpoints. Methods: PubMed, Embase, Cochrane Library and CINAHL Plus databases were searched through 30th November 2016.Results: Of the 854 studies identified initially, 33 observational studies involving 155856 patients were included in our meta-analysis. Tpeak – Tend interval prolongation (mean cut-off: 103.3 ± 17.4 ms) was a significant predictor of the arrhythmic or mortality outcomes (odds ratio (OR): 1.14, 95% CI: 1.11 to 1.17, p < 0.001). When different end-points were analyzed, the ORs are as follows: VT/VF (1.10, 95% CI: 1.06 to 1.13, p < 0.0001), SCD (1.27, 95% CI 1.17 to 1.39, p < 0.0001), cardiovascular death (1.40, 95% CI 1.19 to 1.64, p < 0.0001), and all-cause mortality (4.56, 95% CI 0.62 to 33.68, p < 0.0001). Subgroup analysis for each disease revealed that the risk of VT/VF or death was highest for Brugada syndrome (OR: 5.68, 95% CI: 1.57 to 20.53, p < 0.01), followed by hypertension (OR: 1.52, 95% CI: 1.26 to 1.85, p < .0001), heart failure (OR: 1.07, 95% CI: 1.04 to 1.11, p < .0001) and ischemic heart disease (OR: 1.06, 95% CI: 1.02 to 1.10, p = 0.001). In the general population, a prolonged Tpeak – Tend interval also predicted arrhythmic or mortality outcomes (OR: 1.59, 95% CI: 1.21 to 2.09, p < 0.001).Conclusion: The Tpeak – Tend interval is useful risk stratification tool in different diseases and in the general population.

Item Type: Article
Uncontrolled Keywords: tpeak - tend,dispersion of repolarization,risk stratification,ventricular arrhythmia,sudden cardiac death
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Pure Connector
Date Deposited: 19 May 2017 05:06
Last Modified: 22 Oct 2022 02:41
DOI: 10.1016/j.hrthm.2017.05.031

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