Objectives. Aging and chronic heart failure (CHF) are responsible
for the temporal inhomogeneity of electrocardiogram (ECG) repolarization
phase. In the past, short period repolarization-dispersion
parameters were used as makers of mortality risk in different heart
diseases, yet. Aim of this work was to evaluate risk of mortality or
worsening condition in CHF elderly subjects by mean of these repolarization
variables.
Method. An observational, prospective cohort study was performed,
collecting 5 minutes ECG recordings to assess the mean and
standard deviation (SD) of the following variables: QT end (QTe),
QT peak (QTp) and T peak to T end (Te) in 117 decompensated
CHF (age range: from 49 to 103 years). 30-day mortality and high
levels of NT-pro BNP (<75 percentile) were considered markers of
decompensated CHF.
Results. A total of 27 patients (23%) died during the 30-day followup
(overall mortality rate 23%). Te mean (odd ratio (OR): 1.04, 95%
confidence limit (Cl 7u): 1.02-1.09, p<0.01), NT-pro BNP (OR: 1.00,
95% cl: 1.00-1.00, p<0.01) and LVMI (OR : 0.98, 95% cl: 0.96-0.10,
p<0.05) were associated to risk of mortality at the multivariable logistic
analysis. On the contrary, the same statistical analysis selected TeSD
(OR: 1.36, 95% cl: 1.16-1.59, p<0.001) and LVEF (OR: 0.91, 95% cl:
0.87-0.95, p<0.001) as marker of decompensated CHF.
Conclusion.
In decompensated CHF elderly subjects, Te mean
seem be associated to mortality and TeSD could be considered a risk
factor for CHF worsening and complications. These evidences could
provide useful tools for telemonitoring CHF elderly patients, ameliorating
treatments and outcomes
