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Sanjay Sharma - One of the best experts on this subject based on the ideXlab platform.
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103 prevalence and significance of anTerior T Wave inversion in females
Heart, 2014Co-Authors: Aneil Malhotra, Harshil Dhutia, Sabiha Gati, Rajay Merghani, Mike Walker, Hélder Dores, Ahmed Merghani, Lynne Millar, Michael Papadakis, Sanjay SharmaAbstract:Purpose AnTerior T Wave inversion (V1-V4) is The hallmark of arrhyThmogenic righT venTricular cardiomyopaThy (ARVC). However, iT is widely perceived ThaT anTerior T Wave inversion is also common in female individuals. Previous sTudies in small cohorTs of female aThleTes have demonsTraTed a highly variable prevalence of anTerior T Wave inversion of up To 14%. This sTudy invesTigaTed The prevalence and significance of anTerior T Wave inversion in a large, unselecTed cohorT of female aThleTic and non-aThleTic individuals who underwenT cardiac screening. MeThods BeTween May 2007 and SepTember 2013, 17,708 individuals (n = 5,234; 29.6% females) aged 14–35 underwenT cardiac screening wiTh healTh quesTionnaire, 12-lead ECG and consulTaTion wiTh a cardiologisT. FurTher evaluaTion was dicTaTed by iniTial resulTs. The ECGs of female subjecTs were analysed placing emphasis on The presence of anTerior T Wave inversion, defined as T Wave inversion in ≥2 conTiguous anTerior leads. ResulTs T Wave inversion was presenT in 322 (6.2%) females, The majoriTy confined To The anTerior leads; 73% anTerior, 14% laTeral, 13% inferior. AnTerior T Wave inversion was more prevalenT in compeTiTive aThleTes compared To non-aThleTes (7.02 vs 3.78%, p 16 years of age. The majoriTy of anTerior T Wave inversion (n = 171; 73%) was confined To leads V1-V2, wiTh only 1.2% of females exhibiTing T Wave inversion beyond V2, raising The suspicion of ARVC. MulTivariaTe analysis idenTified black eThniciTy as The sole, independenT predicTor for The presence of anTerior T Wave inversion (OR 3.1, 95% CI 1.2–8.4, p = 0.03). Conclusion In The largesT unselecTed cohorT of females To daTe, The overall prevalence of anTerior T Wave inversion was higher (4.5%) Than Those in previously reporTed sTudies. This was also The case for females of Caucasian eThniciTy. AnTerior T Wave inversion persisTed in a considerable proporTion of females >16 years, excluding The ‘juvenile’ paTTern. AlThough we did noT idenTify ARVC in any females wiTh anTerior T Wave inversion, given The low prevalence of T Wave inversion beyond V2, parTicularly in Caucasian individuals (1.06%), such paTTerns noT be considered a normal finding and should Trigger furTher clinical evaluaTion.
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prevalence and significance of T Wave inversions in predominanTly caucasian adolescenT aThleTes
European Heart Journal, 2009Co-Authors: Michael Papadakis, Sandeep Basavarajaiah, John Rawlins, Carey Edwards, J Makan, Sami Firoozi, Lorna Carby, Sanjay SharmaAbstract:Aims AThleTic acTiviTy is associaTed wiTh elecTrocardiographic T-Wave inversions in some adulTs, resembling Those observed in cardiomyopaThy. The prevalence and significance of T-Wave inversions in adolescenT aThleTes, The group mosT vulnerable To exercise-relaTed sudden deaTh from cardiomyopaThy, is unknown. MeThods and resulTs This sTudy evaluaTed 1710 adolescenT aThleTes and 400 healThy conTrols. SubjecTs wiTh T-Wave inversions underwenT inTensive cardiac invesTigaTions To idenTify a poTenTial cause. There was no significanT difference in The overall prevalence of T-Wave inversions beTween aThleTes and conTrols (4 vs. 3%; P = 0.46). T-Wave inversions in leads V1–V3 were largely confined To aThleTes and conTrols aged <16 years. Only 0.1% of aThleTes aged ≥16 years exhibiTed T-Wave inversions beyond V2. T-Wave inversions in The inferior and/or laTeral leads and deep T-Wave inversions occurred infrequenTly in aThleTes (1.5 and 0.8%, respecTively) and were associaTed wiTh a high prevalence of lefT venTricular hyperTrophy or congeniTal cardiac anomalies. DespiTe inTensive invesTigaTions, no aThleTe was diagnosed wiTh a cardiomyopaThy. Conclusions T-Wave inversions in V1–V3 are relaTively common in aThleTes <16 years and probably represenT The juvenile elecTrocardiogram paTTern. In adolescenT aThleTes, T-Wave inversions beyond V2 if ≥16 years, T-Wave inversions in The inferior/laTeral leads and deep T-Wave inversions in any lead are unusual, warranTing furTher invesTigaTions for underlying cardiomyopaThy.
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PREVALENCE AND SIGNIFICANCE OF T-Wave INVERSIONS IN PREDOMINANTLY CAUCASIAN ADOLESCENT ATHLETES
European Heart Journal, 2009Co-Authors: Michael Papadakis, Sandeep Basavarajaiah, John Rawlins, Carey Edwards, J Makan, Sami Firoozi, Lorna Carby, Sanjay SharmaAbstract:Aims AThleTic acTiviTy is associaTed wiTh elecTrocardiographic T-Wave inversions in some adulTs, resembling Those observed in cardiomyopaThy. The prevalence and significance of T-Wave inversions in adolescenT aThleTes, The group mosT vulnerable To exercise-relaTed sudden deaTh from cardiomyopaThy, is unknown. MeThods and resulTs This sTudy evaluaTed 1710 adolescenT aThleTes and 400 healThy conTrols. SubjecTs wiTh T-Wave inversions underwenT inTensive cardiac invesTigaTions To idenTify a poTenTial cause. There was no significanT difference in The overall prevalence of T-Wave inversions beTween aThleTes and conTrols (4 vs. 3%; P = 0.46). T-Wave inversions in leads V1–V3 were largely confined To aThleTes and conTrols aged
Daniel B. Kramer - One of the best experts on this subject based on the ideXlab platform.
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PosT-pacemaker T-Wave inversions: cardiac memory.
The American Journal of Medicine, 2015Co-Authors: Jonathan W. Waks, Daniel A. Steinhaus, Alexei Shvilkin, Daniel B. KramerAbstract:In cerTain circumsTances, new T-Wave inversions are noTpaThological. A 72-year-old woman wiTh hyperTension,paroxysmal aTrialfibrillaTion, aTrialfluTTer, and Tachycardia-bradycardia syndrome developed frequenT sympTomaTicconversion pauses and underwenT unevenTful implanTaTionof a dual chamber pacemaker. Her elecTrocardiogram(ECG) prior To pacemaker implanTaTion is shown inFigure 1. One week afTer pacemaker implanTaTion, ThepaTienT reTurned for a rouTine medical appoinTmenT. ArepeaT ECG demonsTraTed new, diffuse T-Wave inversions(Figure 2).ThepaTienThadnochesTdiscomforT,dyspnea, or oTher specific sympToms.
Vedat Davutoglu - One of the best experts on this subject based on the ideXlab platform.
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Early T Wave Inversion (Cardiac Memory PaTTern)
Gaziantep Medical Journal, 2010Co-Authors: Murat Yuce, Murat Sucu, Vedat DavutogluAbstract:A 32-year-old man was admiTTed To The coronary care uniT because of wide QRS complex Tachycardia. 12-lead elecTrocardiogram showed a monomorphic regular wide QRS complex Tachycardia wiTh a venTricular raTe of 110 beaTs/minuTe and righT bundle branch black morphology. The paTienT was received synchronized shocks aT energy levels of 200 Joules wiTh normal sinus rhyThm. His elecTrocardiogram afTer The TerminaTion of The wide QRS complex Tachycardia reTurned To sinus rhyThm wiTh T Wave inversions in V1-V6 and DII, DIII, aVF. The indicaTed T-Wave inversions demonsTraTe cardiac memory due To The preceding abnormal venTricular acTivaTion caused by Tachycardia. Because The T Wave inversion occurred afTer The conversion from Tachycardia To sinus rhyThm, iT is illusTraTed by The cardiac memory phenomenon.
Michael Papadakis - One of the best experts on this subject based on the ideXlab platform.
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103 prevalence and significance of anTerior T Wave inversion in females
Heart, 2014Co-Authors: Aneil Malhotra, Harshil Dhutia, Sabiha Gati, Rajay Merghani, Mike Walker, Hélder Dores, Ahmed Merghani, Lynne Millar, Michael Papadakis, Sanjay SharmaAbstract:Purpose AnTerior T Wave inversion (V1-V4) is The hallmark of arrhyThmogenic righT venTricular cardiomyopaThy (ARVC). However, iT is widely perceived ThaT anTerior T Wave inversion is also common in female individuals. Previous sTudies in small cohorTs of female aThleTes have demonsTraTed a highly variable prevalence of anTerior T Wave inversion of up To 14%. This sTudy invesTigaTed The prevalence and significance of anTerior T Wave inversion in a large, unselecTed cohorT of female aThleTic and non-aThleTic individuals who underwenT cardiac screening. MeThods BeTween May 2007 and SepTember 2013, 17,708 individuals (n = 5,234; 29.6% females) aged 14–35 underwenT cardiac screening wiTh healTh quesTionnaire, 12-lead ECG and consulTaTion wiTh a cardiologisT. FurTher evaluaTion was dicTaTed by iniTial resulTs. The ECGs of female subjecTs were analysed placing emphasis on The presence of anTerior T Wave inversion, defined as T Wave inversion in ≥2 conTiguous anTerior leads. ResulTs T Wave inversion was presenT in 322 (6.2%) females, The majoriTy confined To The anTerior leads; 73% anTerior, 14% laTeral, 13% inferior. AnTerior T Wave inversion was more prevalenT in compeTiTive aThleTes compared To non-aThleTes (7.02 vs 3.78%, p 16 years of age. The majoriTy of anTerior T Wave inversion (n = 171; 73%) was confined To leads V1-V2, wiTh only 1.2% of females exhibiTing T Wave inversion beyond V2, raising The suspicion of ARVC. MulTivariaTe analysis idenTified black eThniciTy as The sole, independenT predicTor for The presence of anTerior T Wave inversion (OR 3.1, 95% CI 1.2–8.4, p = 0.03). Conclusion In The largesT unselecTed cohorT of females To daTe, The overall prevalence of anTerior T Wave inversion was higher (4.5%) Than Those in previously reporTed sTudies. This was also The case for females of Caucasian eThniciTy. AnTerior T Wave inversion persisTed in a considerable proporTion of females >16 years, excluding The ‘juvenile’ paTTern. AlThough we did noT idenTify ARVC in any females wiTh anTerior T Wave inversion, given The low prevalence of T Wave inversion beyond V2, parTicularly in Caucasian individuals (1.06%), such paTTerns noT be considered a normal finding and should Trigger furTher clinical evaluaTion.
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prevalence and significance of T Wave inversions in predominanTly caucasian adolescenT aThleTes
European Heart Journal, 2009Co-Authors: Michael Papadakis, Sandeep Basavarajaiah, John Rawlins, Carey Edwards, J Makan, Sami Firoozi, Lorna Carby, Sanjay SharmaAbstract:Aims AThleTic acTiviTy is associaTed wiTh elecTrocardiographic T-Wave inversions in some adulTs, resembling Those observed in cardiomyopaThy. The prevalence and significance of T-Wave inversions in adolescenT aThleTes, The group mosT vulnerable To exercise-relaTed sudden deaTh from cardiomyopaThy, is unknown. MeThods and resulTs This sTudy evaluaTed 1710 adolescenT aThleTes and 400 healThy conTrols. SubjecTs wiTh T-Wave inversions underwenT inTensive cardiac invesTigaTions To idenTify a poTenTial cause. There was no significanT difference in The overall prevalence of T-Wave inversions beTween aThleTes and conTrols (4 vs. 3%; P = 0.46). T-Wave inversions in leads V1–V3 were largely confined To aThleTes and conTrols aged <16 years. Only 0.1% of aThleTes aged ≥16 years exhibiTed T-Wave inversions beyond V2. T-Wave inversions in The inferior and/or laTeral leads and deep T-Wave inversions occurred infrequenTly in aThleTes (1.5 and 0.8%, respecTively) and were associaTed wiTh a high prevalence of lefT venTricular hyperTrophy or congeniTal cardiac anomalies. DespiTe inTensive invesTigaTions, no aThleTe was diagnosed wiTh a cardiomyopaThy. Conclusions T-Wave inversions in V1–V3 are relaTively common in aThleTes <16 years and probably represenT The juvenile elecTrocardiogram paTTern. In adolescenT aThleTes, T-Wave inversions beyond V2 if ≥16 years, T-Wave inversions in The inferior/laTeral leads and deep T-Wave inversions in any lead are unusual, warranTing furTher invesTigaTions for underlying cardiomyopaThy.
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PREVALENCE AND SIGNIFICANCE OF T-Wave INVERSIONS IN PREDOMINANTLY CAUCASIAN ADOLESCENT ATHLETES
European Heart Journal, 2009Co-Authors: Michael Papadakis, Sandeep Basavarajaiah, John Rawlins, Carey Edwards, J Makan, Sami Firoozi, Lorna Carby, Sanjay SharmaAbstract:Aims AThleTic acTiviTy is associaTed wiTh elecTrocardiographic T-Wave inversions in some adulTs, resembling Those observed in cardiomyopaThy. The prevalence and significance of T-Wave inversions in adolescenT aThleTes, The group mosT vulnerable To exercise-relaTed sudden deaTh from cardiomyopaThy, is unknown. MeThods and resulTs This sTudy evaluaTed 1710 adolescenT aThleTes and 400 healThy conTrols. SubjecTs wiTh T-Wave inversions underwenT inTensive cardiac invesTigaTions To idenTify a poTenTial cause. There was no significanT difference in The overall prevalence of T-Wave inversions beTween aThleTes and conTrols (4 vs. 3%; P = 0.46). T-Wave inversions in leads V1–V3 were largely confined To aThleTes and conTrols aged
Christopher Newton-cheh - One of the best experts on this subject based on the ideXlab platform.
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PredicTive value of elecTrocardiographic T-Wave morphology parameTers and T-Wave peak To T-Wave end inTerval for sudden cardiac deaTh in The general populaTion
Circulation: Arrhythmia and Electrophysiology, 2013Co-Authors: Kimmo Porthan, Jani T Tikkanen, Aki S Havulinna, Matti Viitasalo, Lauri Toivonen, Markku S Nieminen, Heikki Väänänen, Heikki V Huikuri, Antti Jula, Christopher Newton-chehAbstract:BACKGROUND: Previous populaTion sTudies have found an associaTion beTween elecTrocardiographic T-Wave morphology parameTers and cardiovascular morTaliTy, buT Their relaTionship To sudden cardiac deaTh (SCD) is noT clear. To our knowledge, There are no follow-up sTudies assessing The associaTion beTween elecTrocardiographic T-Wave peak To T-Wave end inTerval (TPE) and SCD. We assessed The predicTive value of elecTrocardiographic T-Wave morphology parameTers and TPE for SCD in an adulT general populaTion sample.\n\nMETHODS AND RESULTS: A ToTal of 4 T-Wave morphology parameTers (principal componenT analysis raTio, T-Wave morphology dispersion, ToTal cosine R-To-T, T-Wave residuum) as well as TPE were measured from digiTal sTandard 12-lead ECGs in 5618 adulTs (46% men; mean age 50.9±12.5 years) parTicipaTing in The Finnish populaTion-based HealTh 2000 STudy. AfTer a mean follow-up Time of 7.7±1.4 years, 72 SCDs had occurred. In univariable analyses, all T-Wave morphology parameTers were associaTed wiTh an increased SCD risk. In mulTivariable Cox models, T-Wave morphology dispersion and ToTal cosine R-To-T remained as predicTors of SCD, wiTh T-Wave morphology dispersion showing The highesT SCD risk (hazard raTio of 1.4 [95% confidence inTerval 1.1-1.7, P=0.001] per 1 SD increase in The loge T-Wave morphology dispersion). In conTrasT, TPE was noT associaTed wiTh SCD in univariable or mulTivariable analyses.\n\nCONCLUSIONS: ElecTrocardiographic T-Wave morphology parameTers describing The 3-dimensional shape of The T-Wave sTraTify SCD risk in The general populaTion, buT we did noT find an associaTion beTween TPE and SCD.
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RelaTionship of common candidaTe gene varianTs To elecTrocardiographic T-Wave peak To T-Wave end inTerval and T-Wave morphology parameTers.
Heart rhythm, 2010Co-Authors: Kimmo Porthan, Christopher Newton-cheh, Matti Viitasalo, Lauri Toivonen, Markku S Nieminen, Heikki Väänänen, Antti Jula, Annukka Marjamaa, Veikko Salomaa, Kimmo KontulaAbstract:Background Single-nucleoTide polymorphisms (SNPs) in genes encoding cardiac ion channels and niTric oxide synThase-1 adapTor proTein (NOS1AP) are associaTed wiTh elecTrocardiographic (ECG) QT-inTerval duraTion, buT The associaTion of These SNPs wiTh new, prognosTically imporTanT ECG measures of venTricular repolarizaTion is unknown. ObjecTive The purpose of This sTudy was To examine The relaTionship of SNPs To ECG T-Wave peak To T-Wave end (TPE) inTerval and T-Wave morphology parameTers. MeThods We sTudied 5,890 adulTs aTTending The HealTh 2000 STudy, a Finnish epidemiologic survey. TPE inTerval and four T-Wave morphology parameTers were measured from digiTal 12-lead ECGs and relaTed To The seven SNPs showing a phenoTypic effecT on QT-inTerval duraTion in The HealTh 2000 STudy populaTion. ResulTs In mulTivariable analyses, The KCNH2 K897T minor allele was associaTed wiTh a 1.2-ms TPE-inTerval shorTening (P = .00005) and The KCNH2 inTronic rs3807375 minor allele was associaTed wiTh a 0.8-ms TPE-inTerval prolongaTion (P = .001), whereas The KCNE1 D85N varianT had no TPE-inTerval effecT (P = .20). NOS1AP minor alleles (rs2880058, rs4657139, rs10918594, rs10494366) were associaTed wiTh a shorTer TPE inTerval (effecTs from 0.5 To 0.8 ms, P from .032 To .002), which resulTed from Their sTronger effecTs on QTpeak Than QTend inTerval. None of The SNPs showed a consisTenT associaTion wiTh T-Wave morphology parameTers. Conclusion KCNH2 K897T and rs3807375 as well as The four sTudied NOS1AP varianTs have modesT effecTs on ECG TPE inTerval buT are noT relaTed To T-Wave morphology measures. The previously observed prognosTic value of T-Wave morphology parameTers likely is noT based on These SNPs.
