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Tpeak-Tend, Tpeak-Tend/QT ratio and Tpeak-Tend dispersion for risk stratification in Brugada Syndrome: A systematic review and meta-analysis.

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机构: [1]Department of Medicine and Therapeutics, Faculty of Medicine Chinese University of Hong Kong Hong Kong China. [2]Li Ka Shing Institute of Health Sciences, Faculty of Medicine Chinese University of Hong Kong Hong Kong China. [3]Shenzhen Research Institute The Chinese University of Hong Kong Shenzhen China. [4]Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University Tianjin China. [5]Faculty of Medicine Newcastle University Newcastle UK. [6]Aston Medical School Aston University Birmingham UK. [7]Second Department of Cardiology, Laboratory of Cardiac Electrophysiology Evangelismos General Hospital of Athens Athens Greece. [8]Division of Cardiology, Department of Internal Medicine State University of New York at Buffalo Buffalo New York. [9]Heart Rhythm Management Center, Postgraduate Program in Cardiac Electrophysiology and Pacing Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel Brussels Belgium. [10]JC School of Public Health and Primary Care The Chinese University of Hong Kong Hong Kong China. [11]Lankenau Institute for Medical Research and Lankenau Medical Center Wynnewood Pennsylvania. [12]Beijing Anzhen Hospital, Capital Medical University Beijing China. [13]Division of Cardiology Kingston General Hospital, Queen's University Kingston ON Canada.
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关键词: Brugada syndrome risk stratification sudden cardiac death T-peak-T-end ventricular arrhythmia

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Brugada syndrome is an ion channelopathy that predisposes affected subjects to ventricular tachycardia/fibrillation (VT/VF), potentially leading to sudden cardiac death (SCD). Tpeak-Tend intervals, (Tpeak-Tend)/QT ratio and Tpeak-Tend dispersion have been proposed for risk stratification, but their predictive values in Brugada syndrome have been challenged recently. A systematic review and meta-analysis was conducted to examine their values in predicting arrhythmic and mortality outcomes in Brugada Syndrome. PubMed and Embase databases were searched until 1 May 2018, identifying 29 and 57 studies. Nine studies involving 1740 subjects (mean age 45 years old, 80% male, mean follow-up duration was 68 ± 27 months) were included. The mean Tpeak-Tend interval was 98.9 ms (95% CI: 90.5-107.2 ms) for patients with adverse events (ventricular arrhythmias or SCD) compared to 87.7 ms (95% CI: 80.5-94.9 ms) for those without such events, with a mean difference of 11.9 ms (95% CI: 3.6-20.2 ms, P = 0.005; I2 = 86%). Higher (Tpeak-Tend)/QT ratios (mean difference = 0.019, 95% CI: 0.003-0.036, P = 0.024; I2 = 74%) and Tpeak-Tend dispersion (mean difference = 7.8 ms, 95% CI: 2.1-13.4 ms, P = 0.007; I2 = 80%) were observed for the event-positive group. Tpeak-Tend interval, (Tpeak-Tend)/QT ratio and Tpeak-Tend dispersion were higher in high-risk than low-risk Brugada subjects, and thus offer incremental value for risk stratification.

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第一作者机构: [1]Department of Medicine and Therapeutics, Faculty of Medicine Chinese University of Hong Kong Hong Kong China. [2]Li Ka Shing Institute of Health Sciences, Faculty of Medicine Chinese University of Hong Kong Hong Kong China. [3]Shenzhen Research Institute The Chinese University of Hong Kong Shenzhen China.
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