BACKGROUND: Although QTc interval prolongation is considered a risk factor for adverse outcome in the non-transplant population, its predictive value in heart transplant recipients has not been studied yet. This study was conducted to determine whether prolonged QTc interval is a useful predictor of outcome in heart transplant recipients. METHODS: QTc intervals were measured in 587 adult patients who underwent heart transplantation between May 1982 and January 2002. QT interval duration was determined by averaging 3 consecutive beats in all 12 leads of the standard electrocardiogram (ECG) and corrected with the Bazett formula. Baseline ECGs were obtained within 7 days after transplantation; follow-up ECGs were recorded annually at the time of routine angiography. Patients were followed over 85 +/- 65 months (range, 3 months-17 years). RESULTS: During follow-up, 241 patients died. The mean QTc interval duration in these patients was comparable with that in the remaining cohort (432 +/- 26 msec vs 423 +/- 25 msec, p = 0.07). However, patients with a relative increase in QTc duration of >or=10% between the first and second post-transplantation year (DeltaQTc >or= 10%) had a 6.86-times higher risk of dying compared with patients with DeltaQTc < 10% (p = 0.0005). Furthermore, DeltaQTc >or= 10% was the only independent predictor of long-term mortality on multivariate analysis (p = 0.0008). CONCLUSIONS: A relative increase in QTc interval duration of >or=10% between the first and second post-transplantation year is a strong, independent predictor of mortality in heart transplant recipients.
BACKGROUND: Although QTc interval prolongation is considered a risk factor for adverse outcome in the non-transplant population, its predictive value in heart transplant recipients has not been studied yet. This study was conducted to determine whether prolonged QTc interval is a useful predictor of outcome in heart transplant recipients. METHODS: QTc intervals were measured in 587 adult patients who underwent heart transplantation between May 1982 and January 2002. QT interval duration was determined by averaging 3 consecutive beats in all 12 leads of the standard electrocardiogram (ECG) and corrected with the Bazett formula. Baseline ECGs were obtained within 7 days after transplantation; follow-up ECGs were recorded annually at the time of routine angiography. Patients were followed over 85 +/- 65 months (range, 3 months-17 years). RESULTS: During follow-up, 241 patients died. The mean QTc interval duration in these patients was comparable with that in the remaining cohort (432 +/- 26 msec vs 423 +/- 25 msec, p = 0.07). However, patients with a relative increase in QTc duration of >or=10% between the first and second post-transplantation year (DeltaQTc >or= 10%) had a 6.86-times higher risk of dying compared with patients with DeltaQTc < 10% (p = 0.0005). Furthermore, DeltaQTc >or= 10% was the only independent predictor of long-term mortality on multivariate analysis (p = 0.0008). CONCLUSIONS: A relative increase in QTc interval duration of >or=10% between the first and second post-transplantation year is a strong, independent predictor of mortality in heart transplant recipients.
Authors: R Peter Vande Kappelle; Katheryn Gambetta; Barbara J Deal; Carl L Backer; Christine L Sullivan; Elfriede Pahl Journal: Pediatr Cardiol Date: 2010-02-18 Impact factor: 1.655
Authors: Anees Thajudeen; Eric C Stecker; Michael Shehata; Jignesh Patel; Xunzhang Wang; John H McAnulty; Jon Kobashigawa; Sumeet S Chugh Journal: J Am Heart Assoc Date: 2012-04-24 Impact factor: 5.501
Authors: Cristhian F Ramirez-Ramos; Diego A Echeverri-Marin; Clara I Saldarriaga-Giraldo; Juan D Ramirez-Barrera; Juan F Agudelo-Uribe; Ricardo Fernandez-Ruiz; Alvaro Quintero Journal: Arch Cardiol Mex Date: 2022-01-03