Correlation between Epsilon Wave and Late Potentials in Arrhythmogenic Right Ventricular Cardiomyopathy—Do Late Potentials Define the Epsilon Wave?
Abstract
:1. Introduction
2. Methodology
- Study group: ARVC—81 patients with arrhythmogenic right ventricular cardiomyopathy diagnosed on the basis of the International Task Force 2010 Criteria. Late potentials were not taken into account in the diagnosis. This group included 28 women and 53 men, aged 20–78 years.
- Reference group (with two subgroups):
- Ebstein’s Anomaly (EA)—24 patients, including 13 women and 11 men, aged 23–55 years.
- Atrial septal defect (ASD)—29 patients with atrial septal defect scheduled for closure or after closure in adulthood. There were 21 women and 8 men in this group, aged 22–80 years.
Statistical Analysis
3. Results
4. Discussion
5. Limitations of the Study
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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ARVC | ASD + EA | p | ASD | EA | p | |
---|---|---|---|---|---|---|
Gender (female) | 28 (34.6%) | 34 (64.1%) | <0.001 | 21 (72.4%) | 13 (54.2%) | 0.168 |
Mean Age | 47.0 ± 15.8 | 44.5 ± 14.7 | 0.362 | 49.4 ± 13.2 | 38.5 ± 14.5 | 0.006 |
RVOT mm | 40.4 ± 10.5 | 44.2 ± 11.7 | 0.054 | 40.5 ± 8.9 | 49.1 ± 13.3 | 0.013 |
RVIT mm | 47.9 ± 9.2 | 51.8 ± 11.0 | 0.030 | 47.3 ± 8.5 | 57.2 ± 11.5 | <0.001 |
RVEDa cm2 | 33 (26–42) | 29 (24.5–38.5) | 0.196 | 27 (25–30) | 35.0 (24–54) | 0.060 |
TAPSE mm | 18.6 ± 5.7 | 20.2 ± 7.8 | 0.260 | 22.8 ± 7.2 | 16.1 ± 7.0 | 0.010 |
RV S’cm/s | 10.1 ± 3.6 | 11.6 ± 4.1 | 0.054 | 13.3 ± 3.8 | 9.9 ± 3.7 | 0.004 |
LV involvement | 23 (28.4%) | 3 (5.7%) | 0.001 | 1 (3.4%) | 2 (8.3%) | 0.584 |
LVEF % | 60 (50–65) | 60 (57–85) | 0.011 | 65 (60–65) | 59 (55–60) | <0.001 |
Total N = 134 | ARVC N = 81 | ASDE/EA N = 53 | p | Adjusted for * | ||
---|---|---|---|---|---|---|
OR [95% CI] | p | |||||
Echocardiography | ||||||
RVOT > 36 mm * | 81 (63.3%) | 43 (55.8%) | 38 (74.5%) | 0.032 | 0.40 [0.18–0.89] | 0.025 |
RVIT > 41 mm * | 100 (76.3%) | 56 (71.8%) | 44 (83.0%) | 0.138 | 0.42 [0.17–1.05] | 0.065 |
RVEDa > 22 cm2 * | 101 (87.1%) | 58 (90.6%) | 43 (82.7%) | 0.205 | 1.54 [0.49–4.88] | 0.462 |
TAPSE < 16 mm * | 33 (30%) | 23 (31.1%) | 10 (27.8%) | 0.723 | 1.12 [0.45–2.79] | 0.803 |
RV S’ < 9 cm/s * | 36 (30.8%) | 24 (32.4%) | 12 (27.9%) | 0.609 | 1.08 [0.46–2.55] | 0.863 |
ECG | ||||||
Fullfield 2 criteria of LPs | 78 (58.2%) | 52 (64.2%) | 26 (49.1%) | 0.082 | 3.1 [1.2– 8.1] | 0.024 |
Epsilon wave | 31 (23.1%) | 27 (33.3%) | 4 (7.5%) | <0.001 | 15.7 [3.2–77.6] | <0.001 |
Negative T waves (ECG) | 73 (54.5%) | 53 (65.4%) | 20 (37.7%) | 0.002 | 4.9 [1.7–14.6] | 0.004 |
ARVC Group | EW+ n = 27 | EW− n = 54 | OR [95% CI] | p—Wald |
---|---|---|---|---|
Age | 50.4 ± 17.5 | 45.3 ± 14.8 | 1.021 [0.991–1.053] | 0.173 |
Female | 10 (37.0%) | 18 (33.3%) | 1.176 [0.448–3.086] | 0.741 |
ECG examination | ||||
Negative T-waves | 20 (74.1%) | 33 (61.1%) | 1.8 [0.7–5.0] | 0.247 |
Fullfield 2 criteria of LPS | 25 (92.6%) | 27 (50%) | 12.5 [2.691–58.063] | 0.001 |
HF QRS duration | 145.5 ± 30.8 | 105.3 ± 27.6 | 1.042 [1.023–1.061] | <0.001 |
HF_QRS ≥ 114 ms | 22 (81.5%) | 15 (27.8%) | 11.4 [3.7–35.7] | <0.001 |
LAS-40 | 95 (69–116) | 38 (29–56) | 1.041 [1.022–1.060] | <0.001 |
LAS-40 ≥ 38 ms | 25 (92.6%) | 28 (51.8%) | 11.6 [2.5–53.9] | <0.001 |
RMS-40 | 8 (6–14) | 18 (8–28) | 0.924 [0.875–0.976] | 0.004 |
RMS-40 < 20µV | 25 (92.6%) | 28 (51.8%) | 9.3 [2.0–43.2] | 0.004 |
Delta LAS/RMS | 86 (56–114) | 20 [(−2)–48] | 1.031 [1.017–1.046] | <0.001 |
Echocardiographic examination | ||||
RVOT | 48.5 ± 10.4 | 36.2 ± 7.7 | 1.158 [1.080–1.242] | <0001 |
RVIT | 54.8 ± 7.8 | 44.6 ± 8.0 | 1.161 [1.078–1.251] | <0.001 |
RVA | 41 (28–45) | 31 (25–35) | 1.092 [1.027–1.162] | 0.005 |
TAPSE | 16.2 ± 6.4 | 19.7 ± 5.0 | 0.889 [0.808–0.979] | 0.017 |
RVOT | RVIT | RVEDa | TAPSE | RV S’ | ||||||
---|---|---|---|---|---|---|---|---|---|---|
β ± SE | p | β ± SE | p | β ± SE | p | β ± SE | p | β ± SE | p | |
ARVC group | ||||||||||
EW | 8.9 ± 2.2 | <0.001 | 7.2 ± 1.9 | <0.001 | 4.9 ± 2.5 | 0.049 | −2.7 ± 1.2 | 0.030 | −3.1 ± 0.8 | <0.001 |
LP | 7.7 ± 2.1 | <0.001 | 6.2 ± 1.9 | 0.001 | 6.6 ± 2.8 | 0.017 | >0.05 | >0.05 | ||
Negative T | >0.05 | 3.7 ± 1.7 | 0.035 | 6.2 ± 2.4 | 0.011 | −5.3 ± 1.3 | <0.001 | −1.8 ± 0.8 | 0.034 | |
Age | >0.05 | >0.05 | >0.05 | >0.05 | >0.05 | |||||
Male | >0.05 | >0.05 | >0.05 | −3.6 ± 1.2 | 0.005 | −2.1 ± 0.8 | 0.012 | |||
R2 | 0.415 | 0.413 | 0.291 | 0.289 | 0.268 | |||||
ASD + EA group | ||||||||||
RVOT | RVIT | RVEDa | TAPSE | RV S’ | ||||||
β ± SE | p | β ± SE | p | β ± SE | p | β ± SE | p | β ± SE | p | |
EW | 12.7 ±5.4 | 0.025 | >0.05 | >0.05 | >0.05 | >0.05 | ||||
LP | >0.05 | >0.05 | >0.05 | >0.05 | >0.05 | |||||
Negative T | 8.8 ± 3.0 | 0.005 | 9.9 ± 2.8 | 0.001 | 12.2 ± 3.7 | 0.001 | −8.3 ± 2.3 | 0.001 | −4.1 ± 1.0 | <0.001 |
Age | >0.05 | >0.05 | >0.05 | >0.05 | >0.05 | |||||
Male | >0.05 | >0.05 | >0.05 | >0.05 | >0.05 | |||||
R2 | 0.271 | 0.192 | 0.154 | 0.271 | 254 |
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Skrzypczyńska-Banasik, U.; Woźniak, O.; Kowalik, I.; Fronczak-Jakubczyk, A.; Borowiec, K.; Hoffman, P.; Biernacka, E.K. Correlation between Epsilon Wave and Late Potentials in Arrhythmogenic Right Ventricular Cardiomyopathy—Do Late Potentials Define the Epsilon Wave? J. Clin. Med. 2024, 13, 5038. https://doi.org/10.3390/jcm13175038
Skrzypczyńska-Banasik U, Woźniak O, Kowalik I, Fronczak-Jakubczyk A, Borowiec K, Hoffman P, Biernacka EK. Correlation between Epsilon Wave and Late Potentials in Arrhythmogenic Right Ventricular Cardiomyopathy—Do Late Potentials Define the Epsilon Wave? Journal of Clinical Medicine. 2024; 13(17):5038. https://doi.org/10.3390/jcm13175038
Chicago/Turabian StyleSkrzypczyńska-Banasik, Urszula, Olgierd Woźniak, Ilona Kowalik, Aneta Fronczak-Jakubczyk, Karolina Borowiec, Piotr Hoffman, and Elżbieta Katarzyna Biernacka. 2024. "Correlation between Epsilon Wave and Late Potentials in Arrhythmogenic Right Ventricular Cardiomyopathy—Do Late Potentials Define the Epsilon Wave?" Journal of Clinical Medicine 13, no. 17: 5038. https://doi.org/10.3390/jcm13175038