T-Wave Analysis on the 24 h Holter ECG Monitoring as a Predictive Assessment of Major Adverse Cardiovascular Events
Ștefania-Teodora Duca1,2, Mihai Roca1,3, Alexandru-Dan Costache1,3
1Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania.
Insights
Myocardial ischemia, often due to coronary artery disease, poses risks for heart attack and failure. Analyzing T-wave changes via ECG monitoring can predict adverse cardiovascular events, aiding in risk assessment for patients with heart conditions.
Area of Science:
- Cardiology
- Clinical Electrophysiology
Background:
- Myocardial ischemia results from an imbalance in oxygen supply and demand, commonly caused by coronary artery disease.
- It can lead to serious conditions like myocardial infarction and heart failure if untreated.
- Diagnosis relies on clinical assessment, ECG, and imaging.
Purpose of the Study:
- To investigate the prognostic value of electrocardiographic parameters, specifically T-waves, in predicting major adverse cardiovascular events in patients with myocardial ischemia.
- To explore the utility of assessing T-wave electrophysiological heterogeneity in conjunction with myocardial substrate for improved cardiovascular risk stratification.
Main Methods:
- Utilized 24-hour Holter ECG monitoring to assess electrocardiographic parameters in patients with myocardial ischemia.
- Analyzed T-wave characteristics and their electrophysiological heterogeneity.
- Integrated electrocardiographic findings with myocardial substrate assessment.
Main Results:
- Electrocardiographic parameters from 24-hour Holter monitoring independently predicted major adverse cardiovascular events in patients with myocardial ischemia.
- T-wave features demonstrated prognostic value for these events.
- Electrophysiological heterogeneity of T-waves was visualized and found to be significant.
Conclusions:
- 24-hour Holter ECG monitoring provides valuable prognostic information for patients with myocardial ischemia.
- T-wave analysis, including its heterogeneity, is a key factor in predicting adverse cardiovascular outcomes.
- Combining ECG data with myocardial substrate assessment may enhance the prediction of cardiovascular mortality.
Abstract:
Myocardial ischemia is a pathophysiological state characterized by inadequate perfusion of the myocardium, resulting in an imbalance between myocardial oxygen demand and supply. It is most commonly caused by coronary artery disease, in which atherosclerotic plaques lead to luminal narrowing and reduced blood flow to the heart. Myocardial ischemia can manifest as angina pectoris or silent myocardial ischemia and can progress to myocardial infarction or heart failure if left untreated. Diagnosis of myocardial ischemia typically involves a combination of clinical evaluation, electrocardiography and imaging studies. Electrocardiographic parameters, as assessed by 24 h Holter ECG monitoring, can predict the occurrence of major adverse cardiovascular events in patients with myocardial ischemia, independent of other risk factors. The T-waves in patients with myocardial ischemia have prognostic value for predicting major adverse cardiovascular events, and their electrophysiological heterogeneity can be visualized using various techniques. Combining the electrocardiographic findings with the assessment of myocardial substrate may offer a better picture of the factors that can contribute to cardiovascular death.
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