Nd no statistical distinction involving any two ROC curves. The cut-off value, at the same time because the sensitivity and specificity of every single of these four values for predicting the occurrence of adverse cardiac events, are presented in Fig. four. The cut-off values of SI-QTc and QTc dispersion had been higher than the 95th percentile with the data from manage subjects, along with the cut-off value of SD-QTc was larger than the 90th percentile in the information from control subjects. We 1676428 also located that left ventricular mass index drastically correlated with all the presence of adverse cardiac events. In contrast, QRS duration, imply QTc interval, other measurements of left ventricular function, hemoglobin, and serum ferritin level have been not related to adverse cardiac events working with the ROC curve analysis. Discussion This study yielded 3 novel findings: patients with TM had substantially higher spatial 1454585-06-8 site Repolarization heterogeneity, when compared with the wholesome 15481974 subjects; the extent of spatial repolarization heterogeneity detected by MCG correlated using the severity of myocardial iron overload; and spatial repolarization heterogeneity was linked towards the presence of either heart failure Repolarization Heterogeneity in Thalassemia Meanstandard deviation or median Age Male sex n Physique mass index History of diabetes mellitus n Systolic/diastolic blood stress Transfusional blood volume Pretransfusion hemoglobin { Serum ferritin CMR measures Cardiac T2 LV end-diastolic volume index LV end-systolic volume index LV ejection fraction LV mass index Adverse cardiac events n Heart failure n Arrhythmia n Atrial tachycardia Atrial fibrillation and flutter Combined ventricular and atrial tachycardia Second-degree Morbitz type II AV block n = 33; { n = 47. AV = atrioventricular; CMR = cardiac magnetic resonance; LV = left ventricular. doi:10.1371/journal.pone.0086524.t001 27.9 84.4 26.0 70.0 72.8 10 4 9 6 1 1 1 24.566.1 24 20.262.9 7 101612/6569 13250 10.261.2 2002 or arrhythmia. Through the quantification of repolarization heterogeneity, our study results not only demonstrated the potential usefulness of multichannel MCG in the evaluation of TM patients who are at risk for cardiac iron overload, but also highlighted the importance of spatial repolarization heterogeneity in the pathophysiology of iron overload-related cardiac complications. Increased cardiac repolarization heterogeneity has been noted in patients with TM. However, only a few studies investigated spatial repolarization heterogeneity. Rather than analyzing inter-lead variability of QT and JT intervals on the purchase 113-79-1 12-lead ECG tracing used in the previous reports, the present study used a multichannel MCG to detect signals from various locations of the heart, and provided more comprehensive Patients Mean QTc interval SI-QTc SD-QTc QTc dispersion 396630 9.862.5 20.865.6 91.3616.0 Controls 382622 7.361.4 15.563.4 77.8610.0 p 0.006,0.001,0.001,0.001 QTc = corrected QT interval; SI-QTc = smooth index of corrected QT intervals; SD-QTc = standard deviation of corrected QT intervals. doi:10.1371/journal.pone.0086524.t002 measures of the spatial repolarization heterogeneity. We demonstrated that SI-QTc, SD-QTc, and QTc dispersion were all significantly increased in this young cohort of TM patients, whose ventricular geometry and contractility were generally preserved. There was no direct correlation between repolarization heterogeneity and ejection fraction, even in ambulatory heart failure patients and those with clinical arrhythmias. Although the measur.Nd no statistical difference between any 2 ROC curves. The cut-off value, as well because the sensitivity and specificity of each of these 4 values for predicting the occurrence of adverse cardiac events, are presented in Fig. four. The cut-off values of SI-QTc and QTc dispersion had been higher than the 95th percentile in the information from handle subjects, along with the cut-off worth of SD-QTc was higher than the 90th percentile on the information from handle subjects. We 1676428 also located that left ventricular mass index considerably correlated using the presence of adverse cardiac events. In contrast, QRS duration, imply QTc interval, other measurements of left ventricular function, hemoglobin, and serum ferritin level have been not associated with adverse cardiac events applying the ROC curve analysis. Discussion This study yielded 3 novel findings: sufferers with TM had substantially higher spatial repolarization heterogeneity, when compared with the healthful 15481974 subjects; the extent of spatial repolarization heterogeneity detected by MCG correlated together with the severity of myocardial iron overload; and spatial repolarization heterogeneity was linked to the presence of either heart failure Repolarization Heterogeneity in Thalassemia Meanstandard deviation or median Age Male sex n Body mass index History of diabetes mellitus n Systolic/diastolic blood stress Transfusional blood volume Pretransfusion hemoglobin { Serum ferritin CMR measures Cardiac T2 LV end-diastolic volume index LV end-systolic volume index LV ejection fraction LV mass index Adverse cardiac events n Heart failure n Arrhythmia n Atrial tachycardia Atrial fibrillation and flutter Combined ventricular and atrial tachycardia Second-degree Morbitz type II AV block n = 33; { n = 47. AV = atrioventricular; CMR = cardiac magnetic resonance; LV = left ventricular. doi:10.1371/journal.pone.0086524.t001 27.9 84.4 26.0 70.0 72.8 10 4 9 6 1 1 1 24.566.1 24 20.262.9 7 101612/6569 13250 10.261.2 2002 or arrhythmia. Through the quantification of repolarization heterogeneity, our study results not only demonstrated the potential usefulness of multichannel MCG in the evaluation of TM patients who are at risk for cardiac iron overload, but also highlighted the importance of spatial repolarization heterogeneity in the pathophysiology of iron overload-related cardiac complications. Increased cardiac repolarization heterogeneity has been noted in patients with TM. However, only a few studies investigated spatial repolarization heterogeneity. Rather than analyzing inter-lead variability of QT and JT intervals on the 12-lead ECG tracing used in the previous reports, the present study used a multichannel MCG to detect signals from various locations of the heart, and provided more comprehensive Patients Mean QTc interval SI-QTc SD-QTc QTc dispersion 396630 9.862.5 20.865.6 91.3616.0 Controls 382622 7.361.4 15.563.4 77.8610.0 p 0.006,0.001,0.001,0.001 QTc = corrected QT interval; SI-QTc = smooth index of corrected QT intervals; SD-QTc = standard deviation of corrected QT intervals. doi:10.1371/journal.pone.0086524.t002 measures of the spatial repolarization heterogeneity. We demonstrated that SI-QTc, SD-QTc, and QTc dispersion were all significantly increased in this young cohort of TM patients, whose ventricular geometry and contractility were generally preserved. There was no direct correlation between repolarization heterogeneity and ejection fraction, even in ambulatory heart failure patients and those with clinical arrhythmias. Although the measur.
