An interplay between left ventricular wall thickness and T-wave alternans in patients with hypertrophic cardiomyopathy in predicting ventricular tachyarrythmic events: is T-wave amplitude difference the reason?

摘要

The contribution by Puntmann et al, provides a fresh insight in the implementation of T-wave alternans (TWA) testing for patients with hypertrophic cardiomyopathy (HCM); the currently prevailing notion is that TWA does not contribute much to the stratification of patients with HCM to those benefitting or not from an implantable cardioverter/defibril-lator. The authors found that echocardiographically-derived maximal and regional left ventricular wall thickness (LVWT) in patients with HCM constitute independent predictors of future ventricular tachy arrhythmic events (VTE). VTE were more frequent in patients with positive or indeterminate TWA. Also interesting associations between age, left ventricular mass, maximal LVWT, and regional LVWT with positive and/or indeterminate TWA were found. The work identifies the LVWT as an independent predictor of a positive response to TWA testing, with a complimentary role in risk stratification of patients with HCM.