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      Potenciais tardios ao eletrocardiograma de alta resolução no domínio do tempo em portadores de insuficiência cardíaca de diferentes etiologias Translated title: Time domain analysis of the signal averaged electrocardiogram to detect late potentials in heart failure patients with different etiologies

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          Abstract

          OBJETIVO: Avaliar freqüência, correlações clínicas e influência prognóstica do potencial tardio no eletrocardiograma de alta resolução, em portadores de insuficiência cardíaca de diferentes etiologias. MÉTODOS: Foi estudado o eletrocardiograma de alta resolução, durante 42 meses, em 288 portadores de insuficiência cardíaca de diferentes etiologias, 215 homens (74,65%) e 73 mulheres (25,35), de idades entre 16 e 70 anos (média 51,5, desvio-padrão 11,24). As etiologias da insuficiência cardíaca foram: cardiomiopatia hipertensiva, 78(27,1%); cardiomiopatia dilatada idiopática, 73(25,4%); cardiomiopatia isquêmica, 65(22,6%); cardiomiopatia da doença de Chagas, 42(14,6%); cardiomiopatia alcoólica, 9(3,1%); cardiomiopatia periparto, 6(2,1%); valvopatias em 2(4,2%) e miocardite viral, 3(1,04%). Foram avaliadas a duração do QRS Standard, duração do QRS filtrado, duração do sinal abaixo de 40µV e a raiz quadrada nos últimos 40ms quanto a idade, sexo, etiologia, achados do eletrocardiograma de repouso de 12 derivações, do ecocardiograma, do eletrocardiograma de longa duração e mortalidade. Para a análise estatística, foram utilizados os testes: exato de Fisher, t de Student, de Man-Whitney, análise de variância, Log-HanK e o método de Kaplan-Meyer. RESULTADOS: O potencial tardio foi diagnosticado em 90 (31,3%) pacientes e não houve correlação com as etiologias. Sua presença associou-se a: menor consumo máximo de oxigênio a cicloergoespirometria (p=0,001); taquicardia ventricular sustentada e não sustentada ao Holter (p=0,001), morte súbita e mortalidade (p<0,05). Houve uma maior sobrevida nos pacientes sem potencial tardio. CONCLUSÃO: A presença de potencial tardio não se associou às etiologias e mostrou-se um marcador de pior prognóstico.

          Translated abstract

          OBJECTIVE: To evaluate the frequency, clinical correlations and prognosis influence of late potentials on the of heart failure patients with different etiologies using the signal averaged electrocardiogram. METHODS: A 42 month study of the signal averaged electrocardiograms of 288 heart failure patients with different etiologies was conducted. The group of patients included 215 males (74.65%) and 73 females (25.35%) between the ages of 16 and 70 (mean 51.5, standard deviation 11.24). The heart failure etiologies were: hypertensive heart disease (78 patients, 27.1%); idiopathic dilated cardiomyopathy (73 patients, 25.4%); ischemic cardiomyopathy (65 patients, 22.6%); Chagas disease (42 patients, 14.6%); alcoholic cardiomyopathy (9 patients, 3.1%); peripartum cardiomyopathy (6 patients, 2.1%); valvular heart disease (2 patients, 4.2%) and viral myocarditis (3 patients, 1.04%). The variables included the duration of the standard QRS complex, duration of the filtered QRS complex, duration of the signal below 40µV and the root mean square of the last 40ms which were analyzed in regard to age, gender, etiology and mortality as well as the findings of the 12-lead electrocardiogram at rest, echocardiogram and ambulatory electrocardiogram. The statistical analysis tests used were: the Fisher exact probability test, Student’s t-test, Mann Whitney test, variance analysis, Log-Hank and the Kaplan-Meyer method. RESULTS: Late potentials were diagnosed in 90 patients (31.3%) and there was no association with the etiologies. The presence of this condition is associated with: a lower maximum oxygen uptake during the ergospirometry (p=0.001); sustained and non-sustained ventricular tachycardia during Holter monitoring (p=0.001), sudden death and mortality (p<0.05). Patients that did not present late potentials had a higher overlife rate. CONCLUSION: The presence of late potentials was not associated with the etiologies and proved to be an indication of a worse prognosis.

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          Most cited references 27

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                abc
                Arquivos Brasileiros de Cardiologia
                Arq. Bras. Cardiol.
                Sociedade Brasileira de Cardiologia - SBC (São Paulo )
                1678-4170
                September 2006
                : 87
                : 3
                : 241-247
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                Article
                S0066-782X2006001600003
                10.1590/S0066-782X2006001600003

                http://creativecommons.org/licenses/by/4.0/

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                Categories
                CARDIAC & CARDIOVASCULAR SYSTEMS

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