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Correspondence Letter by Opthof et al Regarding Article, “Prolonged Tpeak to Tend Interval on the Resting Electrocardiogram Is Associated With Increased Risk of Sudden Cardiac Death” References Downloaded from http://circep.ahajournals.org/ by guest on May 2, 2017 1. Panikkath R, Reinier K, Uy-Evanado A, Teodorescu C, Hattenhauer J, Mariani R, Gunson K, Jui J, Chugh SS. Prolonged Tpeak to Tend interval on the resting electrocardiogram is associated with increased risk of sudden cardiac death. Circ Arrhythm Electrophysiol. 2011;4:441– 447. 2. Smetana P, Schmidt A, Zabel M, Hnatkova K, Franz M, Huber K, Malik M. Assessment of repolarization heterogeneity for prediction of mortality in cardiovascular disease: peak to the end of the T wave interval and nondipolar repolarization components. J Electrocardiol. 2011;44:301–308. 3. Taggart P, Sutton PM, Opthof T, Coronel R, Trimlett R, Pugsley W, Kallis P. Transmural repolarisation in the left ventricle in humans during normooxia and ischaemia. Cardiovasc Res. 2001;50:454 – 462. 4. Opthof T, Coronel R, Janse MJ. Is there a significant transmural gradient in repolarization time in the intact heart? Circ Arrhythm Electrophysiol. 2009;2:89 –96. 5. Antzelevitch C, Sicouri S, Litovsky SH, Lukas A, Krishnan SC, DiDiego JM, Gintant GA, Liu DW. Heterogeneity within the ventricular wall. Electrophysiology and pharmacology of epicardial, endocardial, and M cells. Circ Res. 1991;69:1427–1449. 6. Opthof T, Coronel R, Wilms-Schopman FJG, Plotnikov AN, Shlapakova IN, Danilo P, Rosen MR. Dispersion of repolarization in canine ventricle and the electrocardiographic T wave: Tp-e interval does not reflect transmural dispersion. Heart Rhythm. 2007;4:341–348. 7. Antzelevitch C, Sicouri S, DiDiego JM, Burashnikov A, Viskin S, Shimizu W, Kowey P, Yan G-X, Zhang L. Does Tpeak-Tend provide an index of transmural dispersion in repolarization? Heart Rhythm. 2007;4: 1114 –1116. 8. Opthof T, Coronel R, Janse MJ, Rosen MR. A wedge is not a heart. Heart Rhythm. 2007;4:1116 –1119. 9. Patel C, Burke JF, Patel H, Kowey PR, Antzelevitch C, Yan GX. Is there a significant transmural gradient in repolarization time in the intact heart? Cellular basis of the T wave: a century of controversy. Circ Arrhyth Electrophysiol. 2009;2:80 – 88. 10. Wilson LD, Jennings MM, Rosenbaum DS. Point: M cells are present in the ventricular myocardium. Heart Rhythm. 2011;8:930 –933. 11. Janse MJ, Coronel R, Opthof T. Counterpoint: M cells do not have a functional role in the ventricular myocardium in the intact heart. Heart Rhythm. 2011;9:934 –937. To the Editor: We read with great interest the paper by Panikkath et al.1 The authors conclude that a prolonged Tpeak to Tend (TpTe) interval in lead V5 is an independent risk marker of sudden cardiac death. In another study on male cardiovascular patients, the TpTe interval was significantly shorter in patients dying from any cause compared with those who survived, regardless of whether the TpTe interval was corrected for heart rate or not.2 Thus, the clinical usefulness of the TpTe interval for identifying patients at risk of (sudden cardiac) death is still far from established. Another discussion is the meaning of the TpTe interval in the ECG. We were, therefore, surprised to learn that the TpTe interval is “a measure of transmural dispersion of repolarization in the left ventricle” supported by 3 papers,3–5 of which we (co-)authored 2. In the debate on the meaning of the TpTe interval our position has been6 and is that the TpTe interval is a marker of total (regional) left ventricular dispersion of repolarization, at least in the canine heart, rather than of transmural dispersion of repolarization. Recently, this has led to several vivid debates.4,7–11 Disclosures None. Tobias Opthof, PhD Michiel J. Janse, MD, PhD Ruben Coronel, MD, PhD Experimental Cardiology Group Center for Heart Failure Research, Academic Medical Center Amsterdam Department of Medical Physiology University Medical Center Utrecht Utrecht, the Netherlands (Circ Arrhythm Electrophysiol. 2011;4:e87.) © 2011 American Heart Association, Inc. Circ Arrhythm Electrophysiol is available at http://circep.ahajournals.org e87 DOI: 10.1161/CIRCEP.111.965566 Letter by Opthof et al Regarding Article, ''Prolonged Tpeak to Tend Interval on the Resting Electrocardiogram Is Associated With Increased Risk of Sudden Cardiac Death'' Tobias Opthof, Michiel J. Janse and Ruben Coronel Downloaded from http://circep.ahajournals.org/ by guest on May 2, 2017 Circ Arrhythm Electrophysiol. 2011;4:e87 doi: 10.1161/CIRCEP.111.965566 Circulation: Arrhythmia and Electrophysiology is published by the American Heart Association, 7272 Greenville Avenue, Dallas, TX 75231 Copyright © 2011 American Heart Association, Inc. All rights reserved. Print ISSN: 1941-3149. Online ISSN: 1941-3084 The online version of this article, along with updated information and services, is located on the World Wide Web at: http://circep.ahajournals.org/content/4/6/e87 Permissions: Requests for permissions to reproduce figures, tables, or portions of articles originally published in Circulation: Arrhythmia and Electrophysiology can be obtained via RightsLink, a service of the Copyright Clearance Center, not the Editorial Office. 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