The University of Southampton
University of Southampton Institutional Repository

Use of troponin to diagnose periprocedural myocardial infarction: effect on composite endpoints in the British Bifurcation Coronary Study (BBC ONE)

Use of troponin to diagnose periprocedural myocardial infarction: effect on composite endpoints in the British Bifurcation Coronary Study (BBC ONE)
Use of troponin to diagnose periprocedural myocardial infarction: effect on composite endpoints in the British Bifurcation Coronary Study (BBC ONE)
AIMS: The markers of ventricular repolarization corrected QT interval (QTc), QT dispersion (QTD) and Tpeak-to-Tend interval (Tpeak-end) have shown an association with sudden cardiac death (SCD) in the general population. However, their mechanistic relationship with SCD is unclear. The study aim was to evaluate the relationship between QTc, QTD, and Tpeak-end, and the extent and distribution of left ventricular (LV) scar in patients with coronary artery disease at high SCD risk.

METHODS AND RESULTS: We included 64 consecutive implantable cardioverter defibrillator (ICD) recipients (66 ± 11 years, 80% male, median left ventricular ejection fraction 30%) who had undergone late gadolinium enhancement cardiac magnetic resonance (CMR) imaging prior to device implantation over 4 years. Scar was quantified using the CMR images and characterized in terms of percent LV scar and number of LV segments with subendocardial/transmural scar. Repolarization parameters were measured on an electrocardiogram performed prior to ICD implantation. After adjustment for potential confounders there was a strong association between the number of limited subendocardial (1-25% transmurality) scar segments and QTc (P = 0.003), QTD (P = 0.002), and Tpeak-end (P = 0.008). However, there was no association between the repolarization parameters and percent LV scar or the amount of transmural scar. During a mean follow-up of 19 ± 10 months 19 (30%) patients received appropriate ICD therapy, but none of the repolarization parameters were associated with its occurrence.

CONCLUSION: In this pilot study there was a strong association between limited subendocardial LV scar and prolonged QTc, QTD, and Tpeak-end. However, there was no association between any of these repolarization markers and the delivery of appropriate ICD therapy.

1431-1435
Cockburn, J.
0d0c7ef5-af6c-47b1-9bb6-01e8e740444f
Behan, M.
abb302e1-57c6-468e-ba75-864820e1b1ee
De Belder, A.
e807fdba-2146-4503-a70a-e77597af4f3b
Clayton, T.
d942929b-d30e-4679-8b95-3c17cc83cd20
Stables, R.
6aaefe18-cce7-42a8-a160-5bcd8763554b
Oldroyd, K.
d24e546a-5a98-496a-8267-c86c5974a710
Curzen, N.
70f3ea49-51b1-418f-8e56-8210aef1abf4
Hildick-Smith, D.
511ddc70-0414-40bb-9487-028bd90cf23d
Cockburn, J.
0d0c7ef5-af6c-47b1-9bb6-01e8e740444f
Behan, M.
abb302e1-57c6-468e-ba75-864820e1b1ee
De Belder, A.
e807fdba-2146-4503-a70a-e77597af4f3b
Clayton, T.
d942929b-d30e-4679-8b95-3c17cc83cd20
Stables, R.
6aaefe18-cce7-42a8-a160-5bcd8763554b
Oldroyd, K.
d24e546a-5a98-496a-8267-c86c5974a710
Curzen, N.
70f3ea49-51b1-418f-8e56-8210aef1abf4
Hildick-Smith, D.
511ddc70-0414-40bb-9487-028bd90cf23d

Cockburn, J., Behan, M., De Belder, A., Clayton, T., Stables, R., Oldroyd, K., Curzen, N. and Hildick-Smith, D. (2012) Use of troponin to diagnose periprocedural myocardial infarction: effect on composite endpoints in the British Bifurcation Coronary Study (BBC ONE). Heart, 98 (19), 1431-1435. (doi:10.1136/heartjnl-2012-302211). (PMID:22851684)

Record type: Article

Abstract

AIMS: The markers of ventricular repolarization corrected QT interval (QTc), QT dispersion (QTD) and Tpeak-to-Tend interval (Tpeak-end) have shown an association with sudden cardiac death (SCD) in the general population. However, their mechanistic relationship with SCD is unclear. The study aim was to evaluate the relationship between QTc, QTD, and Tpeak-end, and the extent and distribution of left ventricular (LV) scar in patients with coronary artery disease at high SCD risk.

METHODS AND RESULTS: We included 64 consecutive implantable cardioverter defibrillator (ICD) recipients (66 ± 11 years, 80% male, median left ventricular ejection fraction 30%) who had undergone late gadolinium enhancement cardiac magnetic resonance (CMR) imaging prior to device implantation over 4 years. Scar was quantified using the CMR images and characterized in terms of percent LV scar and number of LV segments with subendocardial/transmural scar. Repolarization parameters were measured on an electrocardiogram performed prior to ICD implantation. After adjustment for potential confounders there was a strong association between the number of limited subendocardial (1-25% transmurality) scar segments and QTc (P = 0.003), QTD (P = 0.002), and Tpeak-end (P = 0.008). However, there was no association between the repolarization parameters and percent LV scar or the amount of transmural scar. During a mean follow-up of 19 ± 10 months 19 (30%) patients received appropriate ICD therapy, but none of the repolarization parameters were associated with its occurrence.

CONCLUSION: In this pilot study there was a strong association between limited subendocardial LV scar and prolonged QTc, QTD, and Tpeak-end. However, there was no association between any of these repolarization markers and the delivery of appropriate ICD therapy.

Full text not available from this repository.

More information

Published date: October 2012
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 355257
URI: https://eprints.soton.ac.uk/id/eprint/355257
PURE UUID: 01b93f18-ac7b-47af-8918-7a5ec471879f

Catalogue record

Date deposited: 19 Aug 2013 13:10
Last modified: 16 Jul 2019 21:27

Export record

Altmetrics

Contributors

Author: J. Cockburn
Author: M. Behan
Author: A. De Belder
Author: T. Clayton
Author: R. Stables
Author: K. Oldroyd
Author: N. Curzen
Author: D. Hildick-Smith

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×