Patient-specific time-varying association between spatial and temporal variability in repolarization and high sensitivity troponin i

Larisa G. Tereshchenko, Albert Feeny

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

We hypothesized that the patient-specific time-varying changes in the spatial and temporal variability in cardiac repolarization (quantified by spatial TT' angle), and in myocardial injury (measured by high sensitivity troponin I, hsTnI), are independently associated with each other. Spatial TT' angle on resting 12-lead ECG (transformed to vectorcardiogram) and hsTnI were measured simultaneously every 3 hours during a 12-hour observation period in a prospective cohort of emergency department patients (n=379; age 57.8±13.2y; 54% female, 64% black), diagnosed with acute coronary syndrome (ACS; n=28), acute decompensated heart failure (ADHF; n=35), or an acute non-cardiac condition (n=316). High (above median) HsTnI in ACS was characterized by significantly larger TT' angle (12±8 vs 5±2 degrees; P=0.01) 12 hours after admission, but not earlier. In adjusted multinomial logit model, spatial TT' angle was associated with ADHF (Relative Risk Ratio 6.24 (95%CI 1.32-29.57; P=0.021), but not ACS. After full adjustment for confounders in random-effect linear regression, a 10 fold increase in hsTnI in a specific study participant was associated with 1.05 (95%CI 0.19-1.92) degrees increase in spatial TT' angle. Longitudinal association of hsTnI and TT' angle was especially prominent in patients with acute non-cardiac conditions, but not in ACS or ADHF.

Original languageEnglish (US)
Title of host publicationComputing in Cardiology Conference, CinC 2016
PublisherIEEE Computer Society
Pages333-336
Number of pages4
Volume43
ISBN (Electronic)9781509008964
StatePublished - Mar 1 2017
Event43rd Computing in Cardiology Conference, CinC 2016 - Vancouver, Canada
Duration: Sep 11 2016Sep 14 2016

Other

Other43rd Computing in Cardiology Conference, CinC 2016
CountryCanada
CityVancouver
Period9/11/169/14/16

ASJC Scopus subject areas

  • Computer Science(all)
  • Cardiology and Cardiovascular Medicine

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    Tereshchenko, L. G., & Feeny, A. (2017). Patient-specific time-varying association between spatial and temporal variability in repolarization and high sensitivity troponin i. In Computing in Cardiology Conference, CinC 2016 (Vol. 43, pp. 333-336). [7868747] IEEE Computer Society.