Prognostic significance of a low T/R ratio in Brugada Syndrome - 21/03/19
, A. Baranchuk 2, F. Bessiere 1, P. Defaye 3, E. Marijon 4, O. Le Vavasseur 5, D. Dobreanu 6, A. Scridon 6, A. Da Costa 7, E. Delacrétaz 8, C. Kouakam 9, R. Eschalier 10, H. Burri 11, P.F. Winum 12, J. Taieb 13, J. Bouet 13, H. Rosianu 14, P. Chevalier 1
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Résumé |
Introduction |
Abnormalities of myocardial repolarization may play a key role in the initiation of ventricular fibrillation (VF) in Brugada syndrome (BrS). Recent studies have shown that the height of the T-waves and the T/R ratio are inversely proportional to the sudden cardiac arrest (SCA) risk in early repolarization syndrome and hypertrophic cardiomyopathy.
Objective |
To study the prognostic value of a low T/R ratio in patients (pts) with a spontaneous Brugada type 1 pattern (SBT1).
Method |
In an international retrospective study, we reviewed 115 pts (mean age 45.1±12.8 years, 91.3% males) with SBT1. Forty-five presented a documented VF and/or SCA at a mean age of 38.7±11.5 years, 20 came from a review of published cases reports. Six ECG markers and the T/R ratio in leads V5 and II were studied. A low T/R ratio was defined by <0.2.
Results |
The T/R ratio was significantly lower in pts with VF/SCA (lead V5: 0.28±0.15 vs. 0.36±0.17, P=0.008; lead II: 0.47±0.33 vs. 0.61±0.51, P=0.04). A low T/R ratio in lead V5 or II was significantly associated with VF/SCA (respectively 44.4% vs. 14.3%, P<0.001 and 22.2% vs. 7.1%, P=0.02). In multivariate analysis by logistic regression, a low T/R ratio in lead V5 was an independent marker of a higher risk of VF/SCA with an OR of 4.11 (P=0.02). Brugada type 1 pattern in peripheral leads, wide QRS in lead V2 and early repolarization were other independent risk markers (see Fig. 1).
Conclusion |
A low T/R ratio in lead V5 is an independent marker for VF/SCA risk in patients with a SBT1.
Le texte complet de cet article est disponible en PDF.Plan
Vol 11 - N° 2
P. 269 - avril 2019 Retour au numéro
Article précédent
- Are procedural parameters predictive of atrial fibrillation recurrence after pulmonary vein isolation using second generation cryoballoon?
- A. Mirolo, G. Viart, A. Savoure, B. Godin, O. Raitiere, H. Eltchaninoff, F. Anselme
- Consistent histologic findings in Brugada syndrome: The stubborn structural substrate
- A. Delinière, F. Bessière, N. Bencie, P. Maury, P. Chevalier
Bienvenue sur EM-consulte, la référence des professionnels de santé.