{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:21:35Z","timestamp":1792524095715,"version":"4.5.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Despite T-wave morphology abnormalities being well-known distinctive ECG features in patients with long QT syndrome (LQTS), the subjectivity of qualitative \u2018eyeballing\u2019 in T-wave characterization still hampers its integration into diagnostic\/prognostic criteria. We herein evaluated whether our quantitative software-based analysis of T-wave morphology (AnTwM) applied to digital ECGs may identify predictors of cardiac events (CEs) in our cohort of LQTS patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We enrolled LQT1, LQT2, and LQT3 patients having at least one digital ECG from our cohort of genotype-confirmed LQTS patients. Automated AnTwM analysis, using Glasgow and Bravo algorithms embedded in the CalECG software (AMPS-IIc, USA), provided scalar descriptors of ventricular repolarization. Cox regression analyses identified potential predictors of CEs (i.e. syncope, sudden cardiac death, resuscitated cardiac arrest, or appropriate shock delivered by implantable cardioverter defibrillators). A total of 467 (58% female) patients were followed up for 15 \u00b1 9 years, including 253 (54.2%) LQT1, 182 (39%) LQT2, and 32 (6.8%) LQT3 patients. Corrected QT interval predicted CEs in the whole population (1\u2005ms QTc increase: HR = 1.01, 95% CI: 1.0\u20131.01, P = 0.03) but not across genotyped subpopulations. Genotype-specific ECG markers associated with a greater risk of CEs were (i) those expressing a delayed accumulation of the mid-late T-wave area (decreased t25 and increased t50) among LQT1 patients and (ii) those expressing T-wave flattening\/widening (decreased T-wave ascending\/descending slopes) among LQT2 patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The software-based AnTwM on digital ECGs represented a reliable tool in clinical practice and identified unique ECG T-wave \u2018fingerprints\u2019 that allowed prediction of CEs in a genotype-specific manner.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euaf213","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T10:16:53Z","timestamp":1759227413000},"source":"Crossref","is-referenced-by-count":3,"title":["Software-based analysis of T-wave morphology: identifying the electrocardiogram signature of high-risk long QT syndrome"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7950-8090","authenticated-orcid":false,"given":"Alessandra Pia","family":"Porretta","sequence":"first","affiliation":[{"name":"CNMR Maladies Cardiaques H\u00e9r\u00e9ditaires Rares, APHP, H\u00f4pital Bichat Claude-Bernard , 46 Rue Henri Huchard, Paris 75018 ,","place":["France"]},{"name":"Service de Cardiologie, Centre Hospitalier Universitaire Vaudois , Rue du Bugnon 46, Lausanne 1011 ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5185-8563","authenticated-orcid":false,"given":"Charles","family":"Morgat","sequence":"additional","affiliation":[{"name":"CNMR Maladies Cardiaques H\u00e9r\u00e9ditaires Rares, APHP, H\u00f4pital Bichat Claude-Bernard , 46 Rue Henri Huchard, Paris 75018 ,","place":["France"]},{"name":"Department of Cardiology, Arnault Tzanck Institute Saint Laurent du Var ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0362-6351","authenticated-orcid":false,"given":"Elodie","family":"Surget","sequence":"additional","affiliation":[{"name":"CNMR Maladies Cardiaques H\u00e9r\u00e9ditaires Rares, APHP, H\u00f4pital Bichat Claude-Bernard , 46 Rue Henri Huchard, Paris 75018 ,","place":["France"]},{"name":"Research Unit on Cardiovascular and Metabolic Diseases, Sorbonne Universit\u00e9, INSERM, UMRS-1166 , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4749-1428","authenticated-orcid":false,"given":"V\u00e9ronique","family":"Fressart","sequence":"additional","affiliation":[{"name":"Research Unit on Cardiovascular and Metabolic Diseases, Sorbonne Universit\u00e9, INSERM, UMRS-1166 , Paris ,","place":["France"]},{"name":"Service de Biochimie M\u00e9tabolique, Groupe Hospitalier Piti\u00e9-Salp\u00eatri\u00e8re , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrien","family":"Bloch","sequence":"additional","affiliation":[{"name":"Research Unit on Cardiovascular and Metabolic Diseases, Sorbonne Universit\u00e9, INSERM, UMRS-1166 , Paris ,","place":["France"]},{"name":"Service de Biochimie M\u00e9tabolique, Groupe Hospitalier Piti\u00e9-Salp\u00eatri\u00e8re , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3382-7680","authenticated-orcid":false,"given":"Nathalie","family":"Neyroud","sequence":"additional","affiliation":[{"name":"CNMR Maladies Cardiaques H\u00e9r\u00e9ditaires Rares, APHP, H\u00f4pital Bichat Claude-Bernard , 46 Rue Henri Huchard, Paris 75018 ,","place":["France"]},{"name":"Research Unit on Cardiovascular and Metabolic Diseases, Sorbonne Universit\u00e9, INSERM, UMRS-1166 , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9195-4317","authenticated-orcid":false,"given":"Fabio","family":"Badilini","sequence":"additional","affiliation":[{"name":"AMPS IIc , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0370-1278","authenticated-orcid":false,"given":"Martino","family":"Vaglio","sequence":"additional","affiliation":[{"name":"AMPS IIc , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1786-9461","authenticated-orcid":false,"given":"Isabelle","family":"Denjoy","sequence":"additional","affiliation":[{"name":"CNMR Maladies Cardiaques H\u00e9r\u00e9ditaires Rares, APHP, H\u00f4pital Bichat Claude-Bernard , 46 Rue Henri Huchard, Paris 75018 ,","place":["France"]},{"name":"Research Unit on Cardiovascular and Metabolic Diseases, Sorbonne 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