000148264 001__ 148264
000148264 005__ 20250115160155.0
000148264 0247_ $$2doi$$a10.1161/CIRCEP.119.007549
000148264 0248_ $$2sideral$$a115905
000148264 037__ $$aART-2019-115905
000148264 041__ $$aeng
000148264 100__ $$0(orcid)0000-0003-4130-5866$$aRamírez, J.
000148264 245__ $$aCardiovascular Predictive Value and Genetic Basis of Ventricular Repolarization Dynamics
000148264 260__ $$c2019
000148264 5060_ $$aAccess copy available to the general public$$fUnrestricted
000148264 5203_ $$aBACKGROUND: Early prediction of cardiovascular risk in the general population remains an important issue. The T-wave morphology restitution (TMR), an ECG marker quantifying ventricular repolarization dynamics, is strongly associated with cardiovascular mortality in patients with heart failure. Our aim was to evaluate the cardiovascular prognostic value of TMR in a UK middle-aged population and identify any genetic contribution. METHODS: We analyzed ECG recordings from 55¿222 individuals from a UK middle-aged population undergoing an exercise stress test in UK Biobank (UKB). TMR was used to measure ventricular repolarization dynamics, exposed in this cohort by exercise (TMR during exercise, TMRex) and recovery from exercise (TMR during recovery, TMRrec). The primary end point was cardiovascular events; secondary end points were all-cause mortality, ventricular arrhythmias, and atrial fibrillation with median follow-up of 7 years. Genome-wide association studies for TMRex and TMRrec were performed, and genetic risk scores were derived and tested for association in independent samples from the full UKB cohort (N=360¿631). RESULTS: A total of 1743 (3.2%) individuals in UKB who underwent the exercise stress test had a cardiovascular event, and TMRrec was significantly associated with cardiovascular events (hazard ratio, 1.11; P=5×10-7), independent of clinical variables and other ECG markers. TMRrec was also associated with all-cause mortality (hazard ratio, 1.10) and ventricular arrhythmias (hazard ratio, 1.16). We identified 12 genetic loci in total for TMRex and TMRrec, of which 9 are associated with another ECG marker. Individuals in the top 20% of the TMRrec genetic risk score were significantly more likely to have a cardiovascular event in the full UKB cohort (18¿997, 5.3%) than individuals in the bottom 20% (hazard ratio, 1.07; P=6×10-3). CONCLUSIONS: TMR and TMR genetic risk scores are significantly associated with cardiovascular risk in a UK middle-aged population, supporting the hypothesis that increased spatio-temporal heterogeneity of ventricular repolarization is a substrate for cardiovascular risk and the validity of TMR as a cardiovascular risk predictor.
000148264 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000148264 590__ $$a4.393$$b2019
000148264 591__ $$aCARDIAC & CARDIOVASCULAR SYSTEMS$$b34 / 138 = 0.246$$c2019$$dQ1$$eT1
000148264 592__ $$a2.469$$b2019
000148264 593__ $$aCardiology and Cardiovascular Medicine$$c2019$$dQ1
000148264 593__ $$aPhysiology (medical)$$c2019$$dQ1
000148264 593__ $$aMedicine (miscellaneous)$$c2019$$dQ1
000148264 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000148264 700__ $$avan Duijvenboden, S.
000148264 700__ $$aAung, N.
000148264 700__ $$0(orcid)0000-0003-3434-9254$$aLaguna, P.$$uUniversidad de Zaragoza
000148264 700__ $$0(orcid)0000-0002-1960-407X$$aPueyo, E.$$uUniversidad de Zaragoza
000148264 700__ $$aTinker, A.
000148264 700__ $$aLambiase, P.D.
000148264 700__ $$aOrini, M.
000148264 700__ $$aMunroe, P.B.
000148264 7102_ $$15008$$2800$$aUniversidad de Zaragoza$$bDpto. Ingeniería Electrón.Com.$$cÁrea Teoría Señal y Comunicac.
000148264 773__ $$g12, 10 (2019), e007549 [11 pp]$$pCirc. Arrhythm. electrophysiol.$$tCirculation-Arrhythmia and Electrophysiology$$x1941-3149
000148264 8564_ $$s363234$$uhttps://zaguan.unizar.es/record/148264/files/texto_completo.pdf$$yVersión publicada
000148264 8564_ $$s2718494$$uhttps://zaguan.unizar.es/record/148264/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000148264 909CO $$ooai:zaguan.unizar.es:148264$$particulos$$pdriver
000148264 951__ $$a2025-01-15-15:06:02
000148264 980__ $$aARTICLE