DNMT3A clonal hematopoiesis — driver mutations in patients with chronic heart failure with mildly reduced ejection fraction of ischemic etiology: an opinion of the problem and the long-term clinical case series

Myocardial repolarization disturbances resulting in an increased value of dispersion of ventricular repolarization (DR) are associated with the development of life-threatening ventricular arrhythmias. The main tool for detection of repolarization disorders is electrocardiography (ECG). This review is devoted to the new knowledge regarding the physiological and clinical significance of DR and its ECG-reflection. The search for scientific literature was performed using e-LIBRARY, CyberLeninka and Pubmed data bases and the keywords (dispersion of repolarization, QT interval dispersion, Tpe interval, Tpe interval dispersion, Tpe/QT ratio) in different Russian and English spellings. The analysis of experimental, clinical and in silico studies demonstrated that the interval between the peak and the end of T-wave (Tpe) and its derivatives (relatively new ECG-indices, not yet widely used in clinical practice — Tpe interval dispersion and Tpe/QT ratio) provide information of both global and local dispersion of ventricular repolarization, being the proven useful predictors of life-threatening arrhythmias associated with the increased repolarization heterogeneity and the total mortality, while the dispersion of QT interval (the most “traditional” index of DR) is the least accurate measure of DR and arrhythmic risk. The threshold values of the considered ECG-indices of DR are given, and the age- and sex-dependence of them is discussed. The peculiarities of T-wave parameters measuring as well as the problems and the prospects of searching for the new arrhythmogenic ECG-indices are discussed.