The value of ECG parameters as markers of treatment response in Fabry cardiomyopathy.

Details

Serval ID
serval:BIB_5F775AFFFA5C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The value of ECG parameters as markers of treatment response in Fabry cardiomyopathy.
Journal
Heart (british Cardiac Society)
Author(s)
Schmied C., Nowak A., Gruner C., Olinger E., Debaix H., Brauchlin A., Frank M., Reidt S., Monney P., Barbey F., Shah D., Namdar M.
ISSN
1468-201X (Electronic)
ISSN-L
1355-6037
Publication state
Published
Issued date
2016
Peer-reviewed
Oui
Volume
102
Number
16
Pages
1309-1314
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish
Abstract
OBJECTIVE: Best treatment outcomes in Fabry disease (FD) associated cardiomyopathy can be obtained when treatment is started as early as possible. The rationale of this study was to assess the role of ECG changes for identification of cardiac involvement and patients at an earlier stage of the disease more likely deriving a benefit from enzyme replacement therapy (ERT).
METHODS: A retrospective analysis of patient data was performed from an observational, longitudinal, prospective cohort. Treatment response was defined as absence or presence of disease progression, defined as new onset or increase in left ventricular (LV) mass >10%. Demographic, clinical, ECG and echocardiographic parameters at baseline were tested for their value in determining absence or presence of disease progression under ERT at 5-year follow-up.
RESULTS: The study population consisted of a total of 38 patients (25 men, mean age 36±13 years, overall median follow-up duration 6.4±1.2 years). Patients in the progression group (14 men, 4 women) had a longer QRS duration (99±11 ms vs 84±13 ms, p<0.05 for men, 93±9 years vs 81±5 years, p<0.05 for women) and QTc interval (401±15 ms vs 372±10 ms, p<0.005 for men) and a higher amount of ECG abnormalities (86% vs 18%, p<0.005 for men and 100% vs 0%, p<0.005 for women) at the time of ERT initiation. An abnormal baseline ECG was significantly associated with disease progression (sensitivity 94.1%, specificity 88.9%, positive likelihood ratio of 8.47, p<0.005).
CONCLUSIONS: An abnormal ECG at the time of treatment initiation is significantly associated with cardiac disease progression in FD. This effect seems to be independent of age, gender or LV mass at baseline and suggests maximal treatment benefit when ERT is initiated before ECG abnormalities develop.
Pubmed
Create date
19/04/2016 17:30
Last modification date
20/08/2019 14:17
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