Comparison of QTc and Troponin Levels in ST Elevation MIs Compared with Non-ST Elevation MIs

Henrie, Nathan; Harvell, Bryan; Ernst, Amy A.; Weiss, Steven J.; Oglesbee, Scott; Sarangarm, Dusadee; Hernández, Lorenzo Silva

doi:10.14423/smj.0000000000000623

Cited by 4 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Whatever the exact ionic mechanism is involved in APD prolongation response to ischemia, it could be noted that absolutely or relatively prolonged repolarization is usually associated with relatively mild ischemic conditions ( Smith et al, 2012 ), including non-ST-segment elevation myocardial infarction (vs. ST-segment elevation myocardial infarction) ( Henrie et al, 2017 ) and chronic intermittent hypoxia ( Morand et al, 2018 ). Local QTc prolongation indicates the presence of viable myocardium in the affected areas ( Ieva et al, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

Prolonged repolarization in the early phase of ischemia is associated with ventricular fibrillation development in a porcine model

et al. 2023

View full text Add to dashboard Cite

Background: Repolarization prolongation can be the earliest electrophysiological change in ischemia, but its role in arrhythmogenesis is unclear. The aim of the present study was to evaluate the early ischemic action potential duration (APD) prolongation concerning its causes, expression in ECG and association with early ischemic ventricular fibrillation (phase 1A VF).Methods: Coronary occlusion was induced in 18 anesthetized pigs, and standard 12 lead ECG along with epicardial electrograms were recorded. Local activation time (AT), end of repolarization time (RT), and activation-repolarization interval (ARIc) were determined as dV/dt minimum during QRS-complex, dV/dt maximum during T-wave, and rate-corrected RT–AT differences, respectively. Patch-clamp studies were done in enzymatically isolated porcine cardiomyocytes. IK(ATP) activation and Ito1 inhibition were tested as possible causes of the APD change.Results: During the initial period of ischemia, a total of 11 pigs demonstrated maximal ARIc prolongation >10 ms at 1 and/or 2.5 min of occlusion (8 and 6 cases at 1 and 2.5 min, respectively) followed by typical ischemic ARIc shortening. The maximal ARIc across all leads was associated with VF development (OR 1.024 95% CI 1.003–1.046, p = 0.025) and maximal rate-corrected QT interval (QTc) (B 0.562 95% CI 0.346–0.775, p < 0.001) in logistic and linear regression analyses, respectively. Phase 1A VF incidence was associated with maximal QTc at the 2.5 min of occlusion in ROC curve analysis (AUC 0.867, p = 0.028) with optimal cut-off 456 ms (sensitivity 1.00, specificity 0.778). The pigs having maximal QTc at 2.5 min more and less than 450 ms significantly differed in phase 1A VF incidence in Kaplan-Meier analysis (log-rank p = 0.007). In the patch-clamp experiments, 4-aminopyridine did not produce any effects on the APD; however, pinacidil activated IK(ATP) and caused a biphasic change in the APD with initial prolongation and subsequent shortening.Conclusion: The transiently prolonged repolarization during the initial period of acute ischemia was expressed in the prolongation of the maximal QTc interval in the body surface ECG and was associated with phase 1A VF. IK(ATP) activation in the isolated cardiomyocytes reproduced the biphasic repolarization dynamics observed in vivo, which suggests the probable role of IK(ATP) in early ischemic arrhythmogenesis.

show abstract

Section: Discussionmentioning

confidence: 99%

Prolonged repolarization in the early phase of ischemia is associated with ventricular fibrillation development in a porcine model

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Se encontró una relación estadísticamente significativa entre los niveles de troponina I y la elevación del complejo ST (valor de p=0.003). En la Universidad de Nuevo México, Henrie et al concluyeron que los participantes con infarto del miocardio con elevación del segmento ST tenían niveles de troponina I más altos (23). Lo cual concuerda con los hallazgos del presente estudio.…”

Section: Discussionunclassified

Comportamiento del infarto agudo de miocardio en una unidad de cuidado intensivo de una ciudad intermedia durante un año.

2020

View full text Add to dashboard Cite

Objetivo: Identificar el comportamiento clínico y paraclínico del infarto de miocardio en una unidad de cuidados intensivos de una ciudad intermedia durante el 2017.Métodos: estudio descriptivo de corte transversal, incluyó 99 registros con diagnóstico de infarto del miocardio al egreso de UCI. Se describieron las variables y se realizaron análisis de varianza y chi2 y se consideró un valor de p<0.05 para diferencias estadísticamente significativas. Resultados: la prevalencia de infarto del miocardio fue 11.8% en UCI. La edad promedio fue 66.8 años. El dolor precordial estuvo presente en 82.8% con una duración promedio de 335 minutos. La irradiación del dolor fue más frecuente a miembro superior izquierdo (13.1%). El infarto sin elevación del complejo ST fue más frecuente (50.5%). Y la localización electrocardiográfica fue en la cara inferior en 28.2%. El promedio de troponina I ultrasensible fue de 28.2 ng/mL. Presentaron complicaciones el 54.5%. La mortalidad fue de 14.1%. La estancia hospitalaria fue 6.5 y la estancia en cuidados críticos tres días. Se encontró relación estadísticamente significativa entre dolor precordial y elevación del segmento ST (p<0.001) y entre troponina I con estancia hospitalaria y elevación del segmento ST (p=0.007 y p=0.003 respectivamente).Conclusión: se identificó que 11.8% de los pacientes que ingresan a la UCI, lo hacen por infarto del miocardio, y una relación estadísticamente significativa entre dolor precordial con elevación del segmento ST y entre el aumento de troponina I con mayor estancia hospitalaria y elevación del segmento ST

show abstract

A Comparison of QTc Intervals in Alcohol Withdrawal Patients Versus Acute Coronary Syndrome Patients

Chu

Azevedo

Ernst

et al. 2017

Southern Medical Journal

View full text Add to dashboard Cite

More patients with EtOH withdrawal-related ED visits had a long QTc than patients presenting with ACS. ED physicians should carefully monitor patients experiencing EtOH withdrawal for cardiac arrhythmias and obtain an ECG. If any medications that prolong the QTc are considered, then an ECG should be obtained before administering medications that may affect the myocardium to make medication safer for the patient.

show abstract

Comparison of QTc and Troponin Levels in ST Elevation MIs Compared with Non-ST Elevation MIs

Abstract: Patients with NSTEMIs had longer QTc intervals and lower troponin I levels than those with STEMIs.

Cited by 4 publications

References 0 publications

Prolonged repolarization in the early phase of ischemia is associated with ventricular fibrillation development in a porcine model

Prolonged repolarization in the early phase of ischemia is associated with ventricular fibrillation development in a porcine model

Comportamiento del infarto agudo de miocardio en una unidad de cuidado intensivo de una ciudad intermedia durante un año.

A Comparison of QTc Intervals in Alcohol Withdrawal Patients Versus Acute Coronary Syndrome Patients

Contact Info

Product

Resources

About