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Background QT dispersion (QTd) is related to regional variations in myocardial repolarization. Our study aims to assess the value of QTd in prediction of myocardial ischemia and its severity during stress imaging. We enrolled one hundred patients having stable coronary artery disease (CAD) and fulfilling the “Appropriateness criteria for cardiac radionuclide imaging” (MPI). They were divided into group I including patients with MPI-detected ischemia (50 patients) and group II including patients with normal perfusion scan (50 patients). We excluded unstable CAD and all other causes affecting QTd. During isotope scan, ECGs were taken and QTd was calculated at rest and at maximum heart rate. Results QTd was significantly higher in the ischemic group both at rest and exercise (P = 0.000). QTd difference, the difference between QTd at rest and stress, was calculated. QTd difference was significantly lower in normal than in ischemic group (P = 0.003). There was a significant positive correlation between QTd difference and defect size (P = 0.04). Conclusion QTd increases in ischemia and the QTd difference (between rest and stress) correlates positively with severity of ischemia. QTd and QTd difference could be used to improve the accuracy of stress imaging test.

Background The angiographically documented association between severity of coronary artery disease (CAD) and aorto-ilio-pudendal (A-I-P) artery disease and vascular erectile dysfunction (ED) was not yet settled. Aim To assess the relation between angiographically proved CAD and A-I-P artery disease in patients with ischemic heart disease (IHD)–associated vascular ED. Methods 60 men were assigned to 3 study groups: Group 1 (n = 25), patients who had IHD and ED; group 2 (n = 25), patients who had IHD and had no ED; group 3 (n = 10), patients who had ED and had no suspected IHD. All patients were subjected to detailed medical, cardiac, and sexual history. International Index of Erectile Function and penile color Doppler ultrasound were used to assess ED. Quantitative coronary angiography and invasive angiography were used to assess the vascular tree for the right and left (A-I-P) arteries. Endothelial markers, that is, endothelial microparticles and endothelial progenitor cells were also assessed. Outcomes The main outcome measures are assessment of ED and angiographically proved CAD and A-I-P artery disease. Results The mean age ± SD of the 3 study groups were 50.4 ± 6.6, 51.4 ± 3.9, and 49.9 ± 6.1 years, respectively, with no statistically significant difference among groups (P = .380). There were significant higher rates of left main (LM) lesions (≥50%), CAD (≥70%), right and left internal pudendal artery lesions, and right and left internal iliac artery lesions in G1 in comparison with G2 and G3. Patients with ED alone had a higher rate of peripheral lesions compared with patients with CAD alone. 10 percent of patients with ED alone had CAD. Patients in G1 had notably higher rates of peripheral lesions than the other groups combined Patients with left internal pudendal artery lesions had a chance by 1.25 and 2.11 times to have LM lesions and significant CAD, respectively. There was a significant increase of endothelial microparticles in G1 in comparison with other groups (P < .05). Clinical Implications The clinical implications are uses of peripheral angiograghy as a diagnostic tool in patients with CAD-associated vascular ED may have a clinical merit. Strengths & Limitations The strengths in the present study are the use of angiography, color Doppler ultrasound, and standardized instruments. The main limitations are the small sample size and lack of intervention and longitudinal data. Conclusion ED correlates more with A-I-P vascular lesions compared with CAD alone. There was a statistically significant association between severity of CAD including LM significant lesions and A-I-P arteries disease in patients with CAD-associated vascular ED.

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