Hospital mortality in decompensated heart failure. A pilot study.

Background/aim: Heart failure is a leading cause of morbidity and mortality worldwide and it is a major cause of emergency department access for cardiovascular disease patients. Aim of this study was to identify the electrocardiographic (ECG) markers, based on short-term temporal repolarization dispersion, capable to individuate decompensated chronic heart failure (CHF) patients at high mortality risk.
Methods: We obtained the following variables from an ECG recording, monitored via mobile phone, during 5-minute recordings in decompensated CHF patients: RR, QT end (QTe), QT peak (QTp) and T peak to T end (Te) and we calculated mean, standard deviation ( _SD ) and normalized index (N).
Results: In-hospital mortality occurred for 25 subjects on 101 studied (25%). Deceased patients showed higher QTe _SD (p < 0.01), Te mean (p < 0.01), Te _SD (p < 0.05), QTeVN (p < 0.05) than the surviving group. Logistic multivariable analysis evidenced that Te mean was a significant predictor of in-hospital mortality (odd ratio: 0.09, 95% confidence limit: 0.02-0.35, p: 0.001). At multiple regression analysis, Te _SD was significantly and positively related only to the NT-pro BNP levels (r: 0.540; p < 0.001). The Te mean (AUC: 0.677 p < 0.01) and Te _SD (AUC: 0.647, p: 0.05) showed significant sensitivity/specificity for the event.
Conclusions: The Te mean and Te _SD seem to be a promising noninvasive clinical marker able to identify patients with decompensated CHF at high risk of in-hospital mortality.
Competing Interests: Declaration of competing interest Every author denies personal or financial conflict of interest regarding this paper.
(Copyright © 2020 Elsevier Inc. All rights reserved.)