Open AccessTotal cosine R‐to‐T for predicting ventricular arrhythmic and mortality outcomes: A systematic review and meta‐analysis
Author(s) -
Tse Gary,
Gong Mengqi,
Wong Cheuk Wai,
Chan Cynthia,
Georgopoulos Stamatis,
Chan Yat Sun,
Yan Bryan P.,
Li Guangping,
Whittaker Paula,
Ciobanu Ana,
AliHasanAlSaegh Sadeq,
Wong Sunny H.,
Wu William K. K.,
Bazoukis George,
Lampropoulos Konstantinos,
Wong Wing Tak,
Tse Lap Ah,
Baranchuk Adrian M.,
Letsas Konstantinos P.,
Liu Tong
Publication year - 2018
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12495
Subject(s) - medicine , cardiology , meta analysis , repolarization , myocardial infarction , ventricular fibrillation , ventricular tachycardia , sudden cardiac death , heart failure , electrophysiology
Background The total cosine R‐to‐T ( TCRT ), a vectorcardiographic marker reflecting the spatial difference between the depolarization and repolarization wavefronts, has been used to predict ventricular tachycardia/fibrillation ( VT / VF ) and sudden cardiac death ( SCD ) in different clinical settings. However, its prognostic value has been controversial. Objective This systematic review and meta‐analysis evaluated the significance of TRCT in predicting arrhythmic and/or mortality endpoints. Methods PubMed and Embase databases were searched through December 31, 2016. Results Of the 890 studies identified initially, 13 observational studies were included in our meta‐analysis. A total of 11,528 patients, mean age 47 years old, 72% male, were followed for 43 ± 6 months. Data from five studies demonstrated lower TCRT values in myocardial infarction patients with adverse events (syncope, ventricular arrhythmias, or sudden cardiac death) compared to those without these events (mean difference = −0.36 ± 0.05, p < .001; I 2 = 48%). By contrast, only two studies analyzed outcomes in heart failure, and pooled meta‐analysis did not demonstrate significant difference in TCRT between event‐positive and event‐negative patients (mean difference = −0.01 ± 0.10, p > .05; I 2 = 80%). Conclusion TCRT is lower in MI patients at high risk of adverse events when compared to those free from such events. It can provide additional risk stratification beyond the use of clinical parameters and traditional electrocardiogram markers. Its value in other diseases such as heart failure requires further studies.