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Lin H, Lin M, Lin T, Ye M. Prognostic Value of PtfV1 in Long-Term Outcomes of Patients with Unstable Angina. Int J Gen Med 2023; 16:6065-6072. [PMID: 38148885 PMCID: PMC10750485 DOI: 10.2147/ijgm.s439105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/29/2023] [Indexed: 12/28/2023] Open
Abstract
Background P-wave terminal force in lead V1 (PtfV1) irregularity has been associated with various cardiovascular conditions, including atrial fibrillation, left ventricular diastolic dysfunction, valvular heart disease, congestive heart failure, stroke, and mortality. However, its prognostic value for unstable angina (UA) has not been extensively studied. To address this knowledge gap, this study aimed to evaluate the long-term predictive significance of PtfV1 at discharge for UA patients. Methods A total of 707 patients with newly diagnosed UA were included in this study. PtfV1 measurements were recorded at admission and discharge. PtfV1(+) was defined as an absolute value above 0.04mm·s, while PtfV1(-) was defined as an absolute value below 0.04mm·s. Based on their PtfV1 values at discharge, patients were categorized into two groups: PtfV1(-) and PtfV1(+). Univariate and multivariate regression analyses were conducted to identify variables that could potentially contribute to the risk of UA. Results Univariate analysis revealed a higher incidence of total adverse outcomes and major adverse cardiovascular events (MACE) in the PtfV1(+) group compared to the PtfV1(-) group, with a risk ratio (RR) of 2.006 [95% confidence interval (95% CI): 1.389-2.896] for total outcomes and an RR of 2.759 (95% CI: 1.870-4.070) for MACE. After adjusting for confounding factors through multivariate analysis, participants with PtfV1(+) had a 46% increased risk [adjusted hazard ratio (HR): 1.458; 95% CI: 1.010-2.104]for total adverse outcomes and an 86% increased risk (adjusted HR: 1.863; 95% CI: 1.246-2.786) for MACE compared to those with PtfV1(-). Conclusion The presence of PtfV1(+) at discharge is an independent predictor of poor outcomes and provides extended prognostic information for UA patients.
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Affiliation(s)
- Huizhong Lin
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou City, People’s Republic of China
| | - Maosen Lin
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou City, People’s Republic of China
| | - Tao Lin
- Department of Epidemiology and Health Statistics, Fujian Medical University, Fuzhou City, People’s Republic of China
| | - Mingfang Ye
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou City, People’s Republic of China
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Ikenouchi H, Koge J, Tanaka T, Yamaguchi E, Egashira S, Doijiri R, Yamazaki H, Sonoda K, Iwata T, Todo K, Ueno Y, Yamagami H, Ihara M, Toyoda K, Koga M. P-wave terminal force in lead V 1 and atrial fibrillation burden in cryptogenic stroke with implantable loop recorders. J Thromb Thrombolysis 2023:10.1007/s11239-023-02816-8. [PMID: 37130975 DOI: 10.1007/s11239-023-02816-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 05/04/2023]
Abstract
Implantable loop recorders (ILRs) are useful for the detection of atrial fibrillation (AF) in patients with cryptogenic stroke (CS). P-wave terminal force in lead V1 (PTFV1) is associated with AF detection; however, data on the association between PTFV1 and AF detection using ILRs in patients with CS are limited. Consecutive patients with CS with implanted ILRs from September 2016 to September 2020 at eight hospitals in Japan were studied. PTFV1 was calculated by 12-lead ECG before ILRs implantation. An abnormal PTFV1 was defined as ≥ 4.0 mV × ms. The AF burden was calculated as a proportion based on the duration of AF to the total monitoring period. The outcomes included AF detection and large AF burden, which was defined as ≥ 0.5% of the overall AF burden. Of 321 patients (median age, 71 years; male, 62%), AF was detected in 106 patients (33%) during the median follow-up period of 636 days (interquartile range [IQR], 436-860 days). The median time from ILRs implantation to AF detection was 73 days (IQR, 14-299 days). An abnormal PTFV1 was independently associated with AF detection (adjusted hazard ratio, 1.71; 95% confidence interval [CI], 1.00-2.90). An abnormal PTFV1 was also independently associated with a large AF burden (adjusted odds ratio, 4.70; 95% CI, 2.50-8.80). In patients with CS with implanted ILRs, an abnormal PTFV1 is associated with both AF detection and a large AF burden.Clinical Trial Registration Information: UMIN Clinical Trials Registry 000044366.
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Affiliation(s)
- Hajime Ikenouchi
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Junpei Koge
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan.
| | - Tomotaka Tanaka
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Eriko Yamaguchi
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Shuhei Egashira
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Ryosuke Doijiri
- Department of Neurology, Iwate Prefectural Central Hospital, Iwate, Japan
| | - Hidekazu Yamazaki
- Department of Neurology and Neuroendovascular Treatment, Yokohama Shintoshi Neurosurgical Hospital, Yokohama, Japan
| | - Kazutaka Sonoda
- Department of Neurology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Tomonori Iwata
- Department of Neurology, Tokai University, Kanagawa, Japan
| | - Kenichi Todo
- Department of Neurology, Osaka University, Osaka, Japan
| | - Yuji Ueno
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroshi Yamagami
- Department of Stroke Neurology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Masatoshi Koga
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
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Huang Z, Zheng Z, Wu B, Tang L, Xie X, Dong R, Luo Y, Li S, Zhu J, Liu J. Predictive value of P wave terminal force in lead V1 for atrial fibrillation: A meta-analysis. Ann Noninvasive Electrocardiol 2020; 25:e12739. [PMID: 32022368 PMCID: PMC7358887 DOI: 10.1111/anec.12739] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 12/20/2019] [Indexed: 12/23/2022] Open
Abstract
Background Several studies have explored the association between P wave terminal force in lead V1 (PTFV1) and risk of atrial fibrillation (AF) occurrence, but the results were controversial. This meta‐analysis aimed to examine whether abnormal PTFV1 could predict AF occurrence. Methods We searched PubMed, Embase, and Cochrane Library databases for articles published before August 25, 2018. Pooled odds ratios (ORs) of AF occurrence were calculated using random‐effects models to explore the significance of PTFV1. Results A total of 12 studies examining 51,372 participants were included, with 9 studies analyzing PTFV1 as a categorical variable and 4 studies analyzing PTFV1 as a continuous variable. As a categorical variable, abnormal PTFV1 (>0.04 mm s) was significantly associated with AF occurrence with a pooled OR of 1.39 (95% confidence interval [CI] 1.08–1.79, p = .01). Subgroup analysis found that ORs of studies in hemodialysis patients (OR = 4.89, 95% CI 2.54–9.90, p < .001) and acute ischemic stroke patients (OR = 1.60, 95% CI 1.14–2.25, p = .007) were higher than general population (OR = 1.15, 95% CI 1.03–1.29, p = .01). Studies from Europe (OR = 1.05, 95% CI 0.91–1.20, p = .51) yielded lower OR of endpoints compared with Asia (OR = 1.89, 95% CI 1.38–2.60, p < .001) and United States (OR = 1.43, 95% CI 1.19–1.72, p < .001). As a continuous variable, PTFV1 was also significantly associated with AF occurrence with a polled OR per 1 standard deviation (SD) change of 1.27 (95% CI 1.02–1.59, p = .03). Conclusions PTFV1 was significantly associated with the risk of AF and was considered to be a good predictor of AF occurrence in population with or without cardiovascular diseases.
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Affiliation(s)
- Zhuoshan Huang
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhenda Zheng
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Bingyuan Wu
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Leile Tang
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xujing Xie
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ruimin Dong
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yanting Luo
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Suhua Li
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jieming Zhu
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jinlai Liu
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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