Hostname: page-component-6bb9c88b65-k72x6 Total loading time: 0 Render date: 2025-07-26T06:40:45.947Z Has data issue: false hasContentIssue false
  • English
  • Français

Prognostic value of ventricular repolarisation parameters in children with dilated cardiomyopathy

Published online by Cambridge University Press:  24 July 2025

Shuo Wang Open the ORCID record for Shuo Wang [Opens in a new window] ,
Miao Wang ,
Ting Zhao ,
Ping Liu ,
Fang Li ,
Liping Liu ,
Erlin Hu ,
Yuwen Wang ,
Runmei Zou  and
Yi Xu
...Show all authors
Shuo Wang
Affiliation:
Department of Pediatric Cardiovasology, Children’s Medical Center, The Second Xiangya Hospital Central South University, Changsha, HN, China Department of Pediatrics, Xiangya Hospital Central South University, Changsha, HN, China
Miao Wang
Affiliation:
Department of Pediatric Cardiovasology, Children’s Medical Center, The Second Xiangya Hospital Central South University, Changsha, HN, China Department of Pediatrics, Xiangya Hospital Central South University, Changsha, HN, China
Ting Zhao
Affiliation:
Department of Pediatric Cardiovasology, Children’s Medical Center, The Second Xiangya Hospital Central South University, Changsha, HN, China
Ping Liu
Affiliation:
Department of Pediatric Cardiovasology, Children’s Medical Center, The Second Xiangya Hospital Central South University, Changsha, HN, China
Fang Li
Affiliation:
Department of Pediatric Cardiovasology, Children’s Medical Center, The Second Xiangya Hospital Central South University, Changsha, HN, China
Liping Liu
Affiliation:
Department of Pediatric Cardiology, Children’s Medical Center, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, HN, China
Erlin Hu
Affiliation:
Department of Pediatrics, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, Changsha, HN, China
Yuwen Wang
Affiliation:
Department of Pediatric Cardiovasology, Children’s Medical Center, The Second Xiangya Hospital Central South University, Changsha, HN, China
Runmei Zou
Affiliation:
Department of Pediatric Cardiovasology, Children’s Medical Center, The Second Xiangya Hospital Central South University, Changsha, HN, China
Yi Xu
Affiliation:
Department of Pediatric Cardiovasology, Children’s Medical Center, The Second Xiangya Hospital Central South University, Changsha, HN, China
Cheng Wang*
Affiliation:
Department of Pediatric Cardiovasology, Children’s Medical Center, The Second Xiangya Hospital Central South University, Changsha, HN, China
*
Corresponding author: Cheng Wang; Email: wangcheng2nd@csu.edu.cn
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To evaluate the prognostic value of electrocardiographic ventricular repolarisation parameters in children with dilated cardiomyopathy.

Methods:

A retrospective study was conducted involving 89 children with dilated cardiomyopathy [age 5.24 (4.32, 6.15) years] as the research group, and a control group consisting of 80 healthy children matched for age and sex. Within the research group, there were 76 cases in the survival subgroup and 13 cases in the death subgroup. Ventricular repolarisation parameters were measured.

Results:

(1) Compared to the control group, both QTcmax and QTcmin were significantly prolonged in the research group (P < 0.01). Additionally, Tp-Te /QT ratios for leads III, aVL, V1, V2, and V3 showed an increase (P < 0.05), while T-wave amplitudes for leads I, II, aVL, aVF, V4, V5, and V6 exhibited a decrease (P < 0.05). (2) In comparison to the survival subgroup, the diameters of the LV, RV, LA, and RA in the death subgroup were enlarged, while the left ventricular ejection fraction and eft ventricular fractional shortening were decreased (P < 0.05). The Tp-Te /QT ratios for leads aVR, V5, and V6 also increased notably (P < 0.05 or P < 0.01). The T-wave amplitude readings from leads II, aVF, and V6 demonstrated significant reductions (P < 0.05).

Conclusion:

Abnormal ventricular repolarisation parameters were found in dilated cardiomyopathy children. Increased Tp-Te /QT ratios in aVR, V5, and V6 leads and decreased T-wave amplitudes in II, aVF, and V6 leads were risk factors for predicting mortality in children with dilated cardiomyopathy.

Keywords

Dilated cardiomyopathyelectrocardiographyventricular repolarizationprognosisfollow-up

Information

Type
Original Article
Information
Cardiology in the Young , First View , pp. 1 - 7
Check for updates
Copyright
© The Author(s), 2025. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Lipshultz, SE, Law, YM, Asante-Korang, A et al. Cardiomyopathy in children: classification and diagnosis: a scientific statement from the American heart association. Circulation 2019; 140: e9–e68.CrossRefGoogle ScholarPubMed
Reichart, D, Magnussen, C, Zeller, T, Blankenberg, S. Dilated cardiomyopathy: from epidemiologic to genetic phenotypes: a translational review of current literature. J Intern Med 2019; 286: 362–372.10.1111/joim.12944CrossRefGoogle ScholarPubMed
Spezzacatene, A, Sinagra, G, Merlo, M et al. Arrhythmogenic phenotype in dilated cardiomyopathy: natural history and predictors of life-threatening arrhythmias. J Am Heart Assoc 2015; 4: e002149.CrossRefGoogle ScholarPubMed
Akhtar, M, Elliott, PM. Risk stratification for sudden cardiac death in non-ischaemic dilated cardiomyopathy. Curr Cardiol Rep 2019; 21: 155.10.1007/s11886-019-1236-3CrossRefGoogle ScholarPubMed
Türe, M, Balık, H, Akın, A, Bilici, M, Nergiz, A. The relationship between electrocardiographic data and mortality in children diagnosed with dilated cardiomyopathy. Eur J Pediatr 2020; 179: 813–819.CrossRefGoogle ScholarPubMed
Vassallo, JA, Cassidy, DM, Kindwall, KE, Marchlinski, FE, Josephson, ME. Nonuniform recovery of excitability in the left ventricle. Circulation 1988; 78: 1365–1372.10.1161/01.CIR.78.6.1365CrossRefGoogle ScholarPubMed
Tereshchenko, LG, Henrikson, CA, Sotoodehnia, N et al. Electrocardiographic deep terminal negativity of the P wave in V(1) and risk of sudden cardiac death: the atherosclerosis risk in communities (ARIC) study. J Am Heart Assoc 2014; 3: e001387.CrossRefGoogle Scholar
Merlo, M, Zaffalon, D, Stolfo, D et al. ECG in dilated cardiomyopathy: specific findings and long-term prognostic significance. J Cardiovasc Med (Hagerstown) 2019; 20 : 450–458.10.2459/JCM.0000000000000804CrossRefGoogle ScholarPubMed
Amiya, E, Tanabe, K, Ikari, Y, Nakajima, Y, Hara, K. Prolonged QRS duration and severity of mitral regurgitation. Circ J 2006; 70: 57–62.10.1253/circj.70.57CrossRefGoogle ScholarPubMed
Konishi, S, Ohtani, T, Mizuno, H et al. Simple electrocardiographic score can predict left ventricular reverse remodeling in patients with non-ischemic cardiomyopathy. Circ Rep 2019; 1 : 171–178.10.1253/circrep.CR-19-0005CrossRefGoogle ScholarPubMed
Nielsen, JB, Graff, C, Rasmussen, PV et al. Risk prediction of cardiovascular death based on the QTc interval: evaluating age and gender differences in a large primary care population. Eur Heart J 2014; 35: 1335–1344.10.1093/eurheartj/ehu081CrossRefGoogle Scholar
Stewart, JM. A new guideline for diagnosis and treatment of syncope in children and adolescents that stimulates further thought and discussion. Sci Bull (Beijing) 2018; 63: 1527–1528.10.1016/j.scib.2018.09.020CrossRefGoogle ScholarPubMed
Sabaz, MN, Akın, A, Bilici, M, Demir, F, Türe, M, Balık, H. Factors affecting mortality in children with dilated cardiomyopathy. Turk J Pediatr 2019; 61: 485–492.10.24953/turkjped.2019.04.003CrossRefGoogle ScholarPubMed
Maron, BJ, Towbin, JA, Thiene, G et al. Contemporary definitions and classification of the cardiomyopathies: an American heart association scientific statement from the council on clinical cardiology, heart failure and transplantation committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation 2006; 113: 1807–1816.CrossRefGoogle ScholarPubMed
Jefferies, JL, Towbin, JA. Dilated cardiomyopathy. Lancet 2010; 375: 752–762.10.1016/S0140-6736(09)62023-7CrossRefGoogle ScholarPubMed
Tan, C, Yi, X, Chen, Y et al. The changes of T-wave amplitude and QT interval between the supine and orthostatic electrocardiogram in children with dilated cardiomyopathy. Front Pediatr 2021; 9: 680923.10.3389/fped.2021.680923CrossRefGoogle ScholarPubMed
Wang, Y, Xu, Y, Zou, R et al. Effect of levocarnitine on the therapeutic efficacy of conventional therapy in children with dilated cardiomyopathy: results of a randomized trial in 29 children. Paediatr Drugs 2018; 20: 285–290.CrossRefGoogle ScholarPubMed
Taliercio, CP, Seward, JB, Driscoll, DJ, Fisher, LD, Gersh, BJ, Tajik, AJ. Idiopathic dilated cardiomyopathy in the young: clinical profile and natural history. J Am Coll Cardiol 1985; 6: 1126–1131.10.1016/S0735-1097(85)80319-3CrossRefGoogle Scholar
Morris, JJ Jr, Estes, EH Jr, Whalen, RE, Thompson, HK Jr, Mcintosh, HD. P-wave analysis in valvular heart disease. Circulation 1964; 29: 242–252.10.1161/01.CIR.29.2.242CrossRefGoogle ScholarPubMed
Das, MK, Suradi, H, Maskoun, W et al. Fragmented wide QRS on a 12-lead ECG: a sign of myocardial scar and poor prognosis. Circ Arrhythm Electrophysiol 2008; 1: 258–268.10.1161/CIRCEP.107.763284CrossRefGoogle ScholarPubMed
Masarone, D, Valente, F, Rubino, M et al. Pediatric heart failure: a practical guide to diagnosis and management. Pediatr Neonatol 2017; 58: 303–312.10.1016/j.pedneo.2017.01.001CrossRefGoogle ScholarPubMed
Merlo, M, Zaffalon, D, Stolfo, D et al. ECG in dilated cardiomyopathy: specific findings and long-term prognostic significance. J Cardiovasc Med (Hagerstown) 2019; 20: 450–458.10.2459/JCM.0000000000000804CrossRefGoogle ScholarPubMed
Levis, JT. ECG diagnosis: hyperacute T waves. Perm J 2015; 19: 79–79.10.7812/TPP/14-243CrossRefGoogle ScholarPubMed
Weise, LD, Panfilov, AV. A discrete electromechanical model for human cardiac tissue: effects of stretch-activated currents and stretch conditions on restitution properties and spiral wave dynamics. PLoS One 2013; 8: e59317.10.1371/journal.pone.0059317CrossRefGoogle ScholarPubMed
Fauchier, L, Douglas, J, Babuty, D, Cosnay, P, Fauchier, JP. QT dispersion in nonischemic dilated cardiomyopathy. A long-term evaluation. Eur J Heart Fail 2005; 7: 277–282.10.1016/j.ejheart.2004.07.009CrossRefGoogle ScholarPubMed
Ozdemir, R, Isguder, R, Kucuk, M et al. A valuable tool in predicting poor outcome due to sepsis in pediatric intensive care unit: tp-e/QT ratio. J Trop Pediatr 2016; 62: 377–384.10.1093/tropej/fmw021CrossRefGoogle ScholarPubMed
Porthan, K, Viitasalo, M, Toivonen, L et al. Predictive value of electrocardiographic T-wave morphology parameters and T-wave peak to T-wave end interval for sudden cardiac death in the general population. Circ Arrhythm Electrophysiol 2013; 6: 690–696.10.1161/CIRCEP.113.000356CrossRefGoogle ScholarPubMed