Correlation of corrected QT interval with quantitative cardiac troponin-I levels and its prognostic role in Non-ST-elevation myocardial infarction

Rajvanshi, Satyam; Nath, Ranjit Kumar; Kumar, Manoj; Gupta, Ankit; Pandit, Neeraj

doi:10.1016/j.ijcard.2017.03.091

Cited by 6 publications

(9 citation statements)

References 29 publications

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“…Additionally, QT-prolongation has been described as a prognostic parameter in Non-ST-Elevation Myocardial Infarction (NSTEMI) patients. Rajvanshi et al defined the corrected QT Interval above 468 ms as a cut-off value to predict poor prognosis for the occurrence of major adverse cardiac events (MACE) with a sensitivity of 72% and a specificity of 61% [13] .…”

Section: Arrhythmogenic Risk In the Setting Of Qt-interval Prolongatimentioning

confidence: 99%

QTc evaluation in patients with bundle branch block

Bogossian

Linz

Heijman

et al. 2020

IJC Heart & Vasculature

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Proper measurement of the QT interval on the 12-lead body-surface ECG is challenging in daily practice. Even more difficult is its correct estimation in the presence of repolarization abnormalities, arrhythmias or bundle-branch blocks (BBB). The QT interval results from two parts of the ECG: (1) the QRS complex, describing the excitation of the ventricles and (2) the JT interval, describing the repolarisation of the ventricles. Prolongation of the QRS width – like in the presence of BBB – entails prolongation of the QT interval, making the estimation of the true repolarisation time challenging. The US recommendations for the standardization and interpretation of the ECG suggest focusing on the JT interval in presence of BBB. However, in clinical practice physicians have become more familiar with the interpretation of QT-interval measurements than with the interpretation of the JT Interval. In the last decade, a simple formula for the estimation of the “modified QT interval” in the presence of left or right BBB has been developed and evaluated. In this formula, the modified QT interval is calculated by subtracting 50% of the length of the BBB-QRS from the measured QT interval (QT m = QT BBB − 50% QRS BBB ). Subsequently, rate-correction formula should be applied as usual. In this review, we discuss the determination of the QT-interval in the presence of BBB and summarize the origin and application of the modified QT-interval formula.

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Section: Arrhythmogenic Risk In the Setting Of Qt-interval Prolongatimentioning

confidence: 99%

QTc evaluation in patients with bundle branch block

Bogossian

Linz

Heijman

et al. 2020

IJC Heart & Vasculature

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“…We conclude that there was an association between myocardial injury (marked by an increase of hs-troponin I more than 15 ng/L compared to baseline) and heterogeneity of myocardial repolarization (marked by high value of TpTe post chemotherapy). Rajvanshi et al [ 22 ] also found an association between repolarization heterogeneity (represented by QT interval) and myocardial injury quantified by troponin I in patients with acute coronary syndrome.…”

Section: Discussionmentioning

confidence: 99%

Cardiotoxicity by Anthracycline Regimen Chemotherapy Prolonged T Peak to T End Interval

et al. 2020

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Background Myocardial necrosis may occur due to anthracycline (doxorubicin/adriamycin) chemotherapy usage. Furthermore, myocardial necrosis can affect the heterogeneity of heart conduction system and lead to repolarization abnormalities. The aim of this study was to investigate the effect of cardiotoxicity caused by anthracycline to repolarization abnormalities measured by T peak to T end (TpTe) interval. Methods This was a single center prospective cohort study with linear regression from October 2018 to May 2019. The subjects of the study were breast cancer patients after completing administration of chemotherapy with fluorouracil, adriamycin and cyclophosphamide (FAC) regimen (containing anthracycline) for 6 months. Myocardial necrosis was assessed by high sensitive (hs)-troponin I, and the heterogeneity of repolarization was measured by TpTe interval. Results This study involved 25 breast cancer patients after chemotherapy in the 6-month FAC regimen. The mean age is 46 ± 7 years, and the cumulative dose of anthracycline is 591 ± 52 mg/m 2 . The mean level of hs-troponin I is 90.5 ± 44.7 ng/L and the TpTe interval is 108.2 ± 10 ms. The results of linear regression analysis showed a positive correlation between hs-troponin I and TpTe interval (r: 0.421, P: 0.036) after controlling for one confounding variable (cumulative dose of anthracycline). Conclusions Cardiotoxicity caused by accumulative dose of anthracycline may lead to myocardial necrosis which was shown by elevated hs-troponin I levels. This process may lead to heterogeneity conduction system that affect the repolarization phase of cardiac cycle which was shown by increased TpTe interval.

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“…Si bien el intervalo QTc no está incluido en la escala GRACE, en este estudio se encontró relación significativa en los pacientes de bajo riesgo. La medición del intervalo QTc ofrece mucha información pronóstica en diversos escenarios, en la población general un intervalo QTc prolongado puede estar asociado al desarrollo de enfermedad coronaria (4,7) ; para pacientes con enfermedad coronaria ya establecida la prolongación del QT incrementa el riesgo de muerte súbita (5,6) , mientras que en el contexto de un IAM el incremento del mencionado intervalo se asocia con mayor mortalidad tanto en pacientes con o sin elevación del segmento ST (9,10) . En el escenario de un infarto agudo de miocardio (IAM), se desconoce cuál es la mejor fórmula para corregir el intervalo QT, si bien la fórmula de Bazett es la más popular y la más ampliamente usada, esta parece sobrestimar el intervalo QTc (13) ; existen discrepancia con respecto a qué fórmula usar en el escenario de un IAMSEST.…”

Section: Discusionunclassified

“…En el escenario de un infarto agudo de miocardio (IAM), se desconoce cuál es la mejor fórmula para corregir el intervalo QT, si bien la fórmula de Bazett es la más popular y la más ampliamente usada, esta parece sobrestimar el intervalo QTc (13) ; existen discrepancia con respecto a qué fórmula usar en el escenario de un IAMSEST. Dos estudios, uno realizado en España y otro en Irán, utilizaron la fórmula de Bazett (8,11) , mientras que otro, realizado en India, utilizó la fórmula de Hogdes (9) . Dos estudios en un seguimiento a 30 días de pacientes con IAMSEST, encontraron asociación entre el intervalo QTc y eventos cardiovasculares mayores: a mayor intervalo QTc mayor mortalidad cardiovascular (8,9) .…”

Section: Discusionunclassified

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Corrected QT interval and GRACE score relationship in patients with non- ST segment elevation myocardial infarction

Cruz-Aragón

Márquez

Cueva-Parra

et al. 2022

Arch Peru Cardiol Cir Cardiovasc

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Antecedentes. El modelo de predicción del registro global de eventos coronarios agudos (GRACE por sus siglas en inglés) es usado para estratificar el riesgo en pacientes con infarto de miocardio sin elevación del segmento ST (IAMSEST). El intervalo QT corregido (QTc) no se considera en este modelo. Objetivo. Evaluar la relación entre el intervalo QTc con la escala GRACE en pacientes con IAMSEST. Materiales y métodos. Se realizó un estudio observacional retrospectivo entre 2016 y 2019. Se incluyeron pacientes con diagnóstico de IAMSEST, los intervalos QTc se calcularon con la fórmula de Bazett y se clasificaron en dos grupos: intervalo QTc normal (<440 ms) y prolongado (≥440 ms). Según el puntaje GRACE fueron clasificados en tres rangos: riesgo bajo (≤109 puntos), intermedio (110-139 puntos) y alto (≥140 puntos), se determinó si existía relación entre el intervalo QTc y la puntuación GRACE. Resultados. Durante el período mencionado ingresaron en nuestro centro 940 pacientes con diagnóstico de IAMSEST, 634 cumplieron con los criterios de inclusión; hubo 390 pacientes con intervalo QTc normal y 244 con intervalo QTc prolongado. Los pacientes con QTc prolongado eran mayores (65,5 vs. 61, p=0,001) con menor proporción de hombres (71,7% vs. 82,8%, p=0,001). Se encontró asociación entre la escala GRACE y el intervalo QTC, los sujetos con un QTc normal tenían una mayor proporción de riesgo bajo e intermedio que aquellos con un QTc prolongado (p=0,001). Conclusiones. En pacientes con IAMSEST un intervalo QTc normal (<440 ms) se relaciona con una escala de riesgo GRACE de riesgo bajo o intermedio.

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Correlation of corrected QT interval with quantitative cardiac troponin-I levels and its prognostic role in Non-ST-elevation myocardial infarction

Cited by 6 publications

References 29 publications

QTc evaluation in patients with bundle branch block

QTc evaluation in patients with bundle branch block

Cardiotoxicity by Anthracycline Regimen Chemotherapy Prolonged T Peak to T End Interval

Corrected QT interval and GRACE score relationship in patients with non- ST segment elevation myocardial infarction

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