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Correlation between T-Wave Alternans and Cardiac Volume Status via Intrathoracic Impedance Measurements

机译：通过胸内阻抗测量，T波交替蛋白与心脏容量状态之间的相关性

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Introduction. The presence of T-wave alternans (TWA) has been shown to correlate with a higher risk for sudden cardiac death. The mechanism of TWA may be related to abnormalities in intracellular calcium handling, which is a mechanism in heart failure and associated arrhythmias as well. However, an association between TWA and cardiac volume status has not been demonstrated.Methods Used. We report the case of a 54-year-old man with a dilated cardiomyopathy who had a biventricular defibrillator system implanted with intrathoracic impedance measurement capability. We performed baseline TWA testing, which was normal and was associated with normal clinical status and normal intrathoracic impedance. We followed intrathoracic impedance measurements, and when the measurement suggested volume overload eight months later, we repeated the TWA test. TWA was grossly positive, and volume overload was corroborated with clinical heart failure. The patient was diuresed, and when clinical status and intrathoracic impedance returned to normal a month later, we repeated TWA, which was again negative.Conclusion. This case demonstrates a correlation between cardiac volume status, as measured by intrathoracic impedance measurements, and TWA status. This data suggests that conditions of volume overload such as heart failure could be causally related to increased TWA, perhaps by the common mechanism of altered intracellular calcium handling.
机译：介绍。 T波交替蛋白（TWA）的存在已表明与心脏猝死的较高风险相关。 TWA的机制可能与细胞内钙处理异常有关，这是心力衰竭和相关心律失常的机制。但是，尚未证明TWA与心脏容量状态之间的关联。我们报道了一名54岁的扩张型心肌病患者，他的双心室除颤器系统植入了胸内阻抗测量功能。我们进行了基线TWA测试，该测试是正常的，并且与正常的临床状态和正常的胸内阻抗有关。我们进行了胸内阻抗测量，并且当测量结果表明八个月后出现容量超负荷时，我们重复了TWA测试。 TWA总体呈阳性，并且容量超负荷与临床心力衰竭相关。该患者已病痛，当临床状态和胸内阻抗在一个月后恢复正常时，我们重复了TWA，这再次是阴性的。这种情况表明，通过胸腔内阻抗测量所测量的心脏容量状态与TWA状态之间存在相关性。该数据表明，诸如心力衰竭之类的容量超负荷状况可能与TWA增加有关，可能是由于细胞内钙处理改变的共同机制引起的。

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