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The ALPHA study (T-wave alternans in patients with heart failure): rationale, design and endpoints

Jorge A Salerno-Uriarte1, Roberto F E Pedretti, Massimo Tritto

  • 1Department of Cardiovascular Sciences, University of Insubria, Circolo Hospital and Macchi Foundation, Varese, Italy. Jorge.Salerno@ospedale.varese.it

Italian Heart Journal : Official Journal of the Italian Federation of Cardiology
|November 24, 2004
PubMed

Insights

Microvolt T-wave alternans (TWA) may predict cardiac death and arrhythmias in non-ischemic heart failure patients. This study evaluates TWA as a risk marker for sudden cardiac events in this population.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Research

Background:

  • Sudden death and pump failure are primary concerns in heart failure patients.
  • Non-ischemic cardiomyopathy patients face similar arrhythmic mortality risks as ischemic patients but lack routine diagnostic tests.
  • T-wave alternans (TWA) is explored as a potential marker for ventricular tachycardia-fibrillation susceptibility.

Purpose of the Study:

  • To assess the independent predictive value of microvolt T-wave alternans (TWA) measurement.
  • To evaluate TWA's role in predicting cardiac death and life-threatening arrhythmias in non-ischemic dilated cardiomyopathy patients.
  • To analyze outcomes in patients with NYHA class II and III heart failure.

Main Methods:

  • The ALPHA study is a multicenter, prospective, observational trial.
  • 370 patients with non-ischemic dilated cardiomyopathy and measurable TWA were enrolled.
  • Patients were followed for 18 months to record cardiac death and life-threatening ventricular arrhythmias.

Main Results:

  • The study aimed to report findings by 2006.
  • Primary endpoint was the combined incidence of cardiac death and life-threatening ventricular arrhythmias.
  • Data collection involved a logbook for screened patients.

Conclusions:

  • Microvolt T-wave alternans shows potential as a prognostic marker in heart failure.
  • Further research is needed to establish TWA's clinical utility in non-ischemic cardiomyopathy.
  • The findings contribute to understanding arrhythmic risk stratification in heart failure.
Abstract

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