NDLI: Circadian modulation on T-wave alternans activity in chronic heart failure patients

Content Provider	IEEE Xplore Digital Library
Author	Martin-Yebra, Alba Caiani, Enrico G. Laguna, Pablo Monasterio, Violeta Martinez, Juan Pablo
Copyright Year	2015
Description	Author affiliation: BSICoS Group, Aragón Institute of Engineering Research, IIS Aragón, Universidad de Zaragoza, Spain (Laguna, Pablo; Martinez, Juan Pablo) \|\| Universidad San Jorge, Villanueva de Gállego, Spain (Monasterio, Violeta) \|\| Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy (Martin-Yebra, Alba; Caiani, Enrico G)
Abstract	Average TWA activity has been shown to be an independent predictor of sudden cardiac death (SCD) in chronic heart failure (CHF) patients. However, the influence of circadian rhythms on TWA remains understudied. In this work, we assessed circadian TWA changes in a CHF population and evaluated whether the prognostic value of TWA indices is sensitive to the circadian pattern. Holter ECG recordings from 626 consecutive CHF patients (52 SCD) were analyzed. The index of average alternans (IAA), quantifying the average TWA level, was measured in 4 consecutive 6-hour intervals using a multilead fully-automated method. Survival analysis was performed considering SCD as an independent endpoint. IAA changed along the day, with statistically significant lower values during the night than during daytime. This pattern is similar to the one observed in the mean heart rate (HR). However, a low correlation (r=.18) was found between IAA and HR in windows of 128 beats. After dichotomization of patients based on the third quartile of IAA indices, IAA indices computed between hours 06-12 (IAA06–12) and 18–24 (IAA18–24) successfully predicted SCD (Hazard Ratio, HaR:2.34(1.33–4.13)per μV, andHaR:1.87(1.04–3.36) per μV, respectively). In conclusion, circadian variation should be considered for SCD risk prediction.
Starting Page	845
Ending Page	848
File Size	634384
Page Count	4
File Format	PDF
ISBN	9781509006854
ISSN	2325887X
e-ISBN	9781509006847
DOI	10.1109/CIC.2015.7411043
Language	English
Publisher	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Publisher Date	2015-09-06
Publisher Place	France
Access Restriction	Subscribed
Rights Holder	Creative Commons Attribution License 2.5 (CCAL)
Subject Keyword	Electrocardiography Sociology Heart rate Correlation Hazards
Content Type	Text
Resource Type	Article
Subject	Computer Science Cardiology and Cardiovascular Medicine

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4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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