A risk score based on spectral turbulence analysis of the signal averaged ECG for predicting cardiac death in subjects with chronic chagas heart disease
A risk score based on spectral turbulence analysis of the signal averaged ECG for predicting cardiac death in subjects with chronic chagas heart disease
dc.contributor.author | Barbosa, Paulo R. | |
dc.contributor.author | Tura, Bernardo R. | |
dc.contributor.author | Barbosa, Eduardo C. | |
dc.contributor.author | Barbosa-Filho, José | |
dc.contributor.author | Kantharia, Bharat K. | |
dc.date.accessioned | 2023-12-18T14:28:45Z | |
dc.date.available | 2023-12-18T14:28:45Z | |
dc.date.issued | 2010 | |
dc.description.abstract | Introduction: Cardiac involvement is the main cause of death in chronic Chagas disease (CCD). This study prospectively investigated signal-averaged ECG (SAECG), 24h-ambulatory ECG and echocardiogram parameters in CCD aiming at developing a predictive score for death. Methods: Clinically stable outpatients with CCD (34 to 74 y.o, 38 males) staged according to Los Andes (Class I: N=28; II: N=48; III: N=24) were enrolled. Deaths were ascertained by review of medical records. SAECG was acquired on admission. Spectral turbulence analysis (STA) was carried out on XYZ leads after short-time Fourier transform mapping of ventricular activation, and applying intersegment spectral correlation technique. Results: During a follow-up of (mean±SEM) 95.3 ± 3.1 months, 20 patients died (rate: 26.4 ± 1.4/year). In multivariate Cox proportional hazard model, NSVT/24h (p=0.006), LVEF<50% (p<0.001), and positive STA (p=0.001) were independent predictors of death (Table inset). A prognostic score was developed by calculating weighted points proportional to beta coefficient in Cox model (Table inset). ROC analysis showed optimal cut-off value at 5 (Figure A). KM curves of novel score for deaths are presented in Figure B (proportional hazard test: rho=-0.5; p=0.06). In 1,000 bootstraps, ROC c-statistic of novel score was superior to Rassi score (Figure C). Conclusions: In CCD, NSVT, LVEF<50% and high SAECG spectral turbulence are independent predictors of death. A novel risk score improves predictive accuracy in this population. | |
dc.identifier.citation | Barbosa PB, Tura BR, Barbosa EC, Barbosa-Filho J, Kantharia BK. A risk score based on spectral turbulence analysis of the signal averaged ECG for predicting cardiac death in subjects with chronic chagas heart disease. Heart Rhythm. 2010; 7(5): S359. | |
dc.identifier.uri | https://dspace.inc.saude.gov.br/handle/123456789/381 | |
dc.language.iso | en | |
dc.publisher | Heart Rhythm | |
dc.title | A risk score based on spectral turbulence analysis of the signal averaged ECG for predicting cardiac death in subjects with chronic chagas heart disease | |
dc.type | Article |