Warning: Undefined variable $zfal in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 525
Deprecated: str_replace(): Passing null to parameter #3 ($subject) of type array|string is deprecated in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 525
Warning: Undefined variable $sterm in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 530
 free
Warning: Undefined variable $sterm in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 531
 free
 free
Warning: file_get_contents(http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=19560697&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 445
 
English Wikipedia
Nephropedia Template TP (
Twit Text
DeepDyve
Pubget Overpricing |  
l�ll
Microvolt T-wave alternans, peak oxygen consumption, and outcome in patients with severely impaired left ventricular systolic function Gorodeski EZ; Cantillon DJ; Goel SS; Kaufman ES; Martin DO; Hsich EM; Blackstone EH; Lauer MSJ Heart Lung Transplant 2009[Jul]; 28 (7): 689-96BACKGROUND: Abnormal microvolt T-wave alternans (MTWA) and low peak oxygen consumption (VO2) both predict poor outcome in heart failure. However, their independent predictive properties have not been assessed in large-scale cohorts. METHODS: This was an observational prospective cohort study of 303 consecutive patients referred for metabolic stress testing. All had an ejection fraction < or = 40% and were considered candidates for transplantation. The exercise laboratory did not collect MTWA data from patients with implanted pacemakers or defibrillators. The primary end point was a composite of all-cause death or United Network for Organ Sharing status 1 transplantation. RESULTS: During a 2.8-year period, there were 34 deaths and 17 transplantations. Patients with abnormal MTWA had a higher event rate of 23% (31 of 136) vs 12% (20 of 167), with an unadjusted hazard ratio (HR) of 1.90 (95% confidence interval [CI], 1.90-3.33; p = 0.03). The association remained significant after adjustment for 3 clinical variables (HR, 1.89; 95% CI, 1.05-3.39; p = 0.03). After adding peak VO2 to the model, the association was no longer significant (adjusted HR, 1.18; 95% CI, 0.64-2.17, p = 0.60). After accounting for peak VO2 and 28 other confounders in a matched propensity analysis, MTWA was not predictive (propensity-matched HR, 0.79; 95% CI, 0.37-1.66; p = 0.53). CONCLUSIONS: These results confirm the association of abnormal MTWA with poor outcome amongst patients with impaired left ventricular systolic function. However, this association is markedly attenuated after accounting for peak VO2.|*Electrocardiography[MESH]|Adult[MESH]|Cohort Studies[MESH]|Female[MESH]|Follow-Up Studies[MESH]|Heart Rate/physiology[MESH]|Heart Transplantation[MESH]|Humans[MESH]|Kaplan-Meier Estimate[MESH]|Logistic Models[MESH]|Male[MESH]|Middle Aged[MESH]|Oxygen Consumption/*physiology[MESH]|Patient Selection[MESH]|Predictive Value of Tests[MESH]|Prognosis[MESH]|Prospective Studies[MESH]|Stress, Physiological/physiology[MESH]|Stroke Volume/physiology[MESH]|Systole/*physiology[MESH]|Ventricular Dysfunction, Left/*diagnosis/*physiopathology[MESH] |