Effects of ischemia on QT dispersion during spontaneous anginal episodes

Dilaveris, Polychronis; Andrikopoulos, George; Metaxas, Gerasimos; Richter, Dimitri; Avgeropoulou, C.; Androulakis, Aristides; Gialafos, Elias; Michaelides, Andreas; Toutouzas, Pavlos; Gialafos, John

doi:10.1016/s0022-0736(99)90102-4

Cited by 13 publications

(11 citation statements)

References 36 publications

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“…In our series, which focused on patients with STEMI, the values of the minimum QTc increased with the time of evolution of ischemia, the maximum QTc remaining essentially unchanged. The effect of SR of the infarct-related artery on QTc was to reduce the mean values of the maximum QTc, which has been reported by other groups [23] and explains the lower cQTd values associated with SR. This finding could be supportive of the notion that SR restores homogeneity of ventricular repolarization, reducing the duration of prolonged ventricular action potentials.…”

Section: Discussionsupporting

confidence: 70%

“…The increase in cQTd observed in patients with acute ischemia has been related to a prolongation of the maximum QTc [5, 7, 23] and a shortening of the minimum QTc [23, 24]. In our series, which focused on patients with STEMI, the values of the minimum QTc increased with the time of evolution of ischemia, the maximum QTc remaining essentially unchanged.…”

Section: Discussionmentioning

confidence: 65%

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Early Reduction of QT Dispersion after Primary Percutaneous Intervention in ST-Segment Elevation Acute Myocardial Infarction

Jiménez‐Candil

Hernández²,

Aguero³

et al. 2009

Cardiology

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Objectives: To determine, in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PPCI), the mechanisms and clinical implications of the acute changes in QT dispersion (QTd). Methods: In this prospective study we included 216 patients admitted with a STEMI of <12 h of evolution. All were treated with PPCI. QTd was measured prior to PPCI and within 1 h after. Results: The ratio of QTd reduction after PPCI (QTd-R) – defined as [(QTd before PPCI – QTd after PPCI)/QTd before PPCI] ×100 – was significantly correlated with the percentage of ST-segment elevation resolution (ST-R; p < 0.001). To determine the significance of the different values of QTd-R, we further subdivided our population into 3 groups according to the tertiles of QTd-R (<10, 11–49, ≥50%). Patients with longer QTd-R had higher percentages of ST-R: 32 ± 43 for QTd-R <10% vs. 60 ± 21 for 11–49% vs. 71 ± 12 for ≥50% (p < 0.05). By logistic regression, patients with QTd-R ≥50% had a reduction of 75% in the adjusted frequency of death or severe heart failure during hospitalization (95% CI 13–73%, p = 0.03). Conclusion: QTd-R after PPCI occurs early, is closely related to the restoration of reperfusion at the microvascular level and provides additional prognostic information.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 65%

Early Reduction of QT Dispersion after Primary Percutaneous Intervention in ST-Segment Elevation Acute Myocardial Infarction

Jiménez‐Candil

Hernández²,

Aguero³

et al. 2009

Cardiology

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“…According to our findings, as a reflection of reduction in QTd, mechanical reperfusion of the infarct‐related artery could homogenize the duration of the ventricular action potential. The increase in QTc dispersion value observed in patients with acute ischemia has been related to a prolongation of the maximum QTc and a shortening of the minimum QTc . In accordance with this data, our findings showed a nonsignificant reduction in QT maximum and a prolongation in QT minimum values.…”

Section: Discussionsupporting

confidence: 91%

The Comparison in Reduction of QT Dispersion After Primary Percutaneous Coronary Intervention According to Existence of Thrombectomy in ST‐Segment Elevation Myocardial Infarction

Alıcı

Şahin

Özkan

et al. 2013

Clinical Cardiology

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Background:: Primary percutaneous coronary intervention (PPCI) is the standard treatment in patients with ST-segment elevation myocardial infarction (STEMI). Thrombectomy devices are used to remove thrombus or to prevent embolization of thrombus and plaque during PPCI. QT dispersion (the difference between maximal and minimal QT interval calculated on a standard 12-lead electrocardiogram) represents the regional nonuniformity of ventricular repolarization. It may reflect early coronary reperfusion in reducing electrophysiological instability by decreasing QT dispersion in the recovery phase after acute STEMI. Hypothesis: Our aim was to show whether an additional effect of thrombectomy on reducing QT dispersion will be seen in patients undergoing PPCI for STEMI. Methods:: The study population included 80 consecutive patients who were admitted to the hospital within 12 hours after the onset of acute STEMI and angiographic evidence of intraluminal thrombus in the infarct-related artery. Patients with atrial fibrillation or flutter, intraventricular conduction abnormalities, pre-excitation, cardiogenic shock, cardiomyopathy, ventricular hypertrophy, and severe valvular heart disease were excluded from the study. Results: There were no significant differences between groups regarding gender, age, cardiovascular risk factors, and time from symptom onset to treatment, except for smoking, which was much higher in the PPCI plus thrombectomy group. Infarct-related artery distribution (left anterior descending artery [LAD] to non-LAD), and neither the rate of balloon predilatation nor stent implantation were different between groups. Successful coronary patency was achieved in each case. QT interval measurements were similar between groups at admission. However, at 24 hours, QT and QTc dispersions were less in the PPCI plus thrombectomy group (41 ± 9 vs 33 ± 7 ms, P < 0.05 and 45 ± 8 vs 35 ± 7 ms, P = 0.03, respectively), but not in the other QT interval measurements. When patients were divided into 2 groups according to infarct-related artery (LAD and non-LAD groups), QT interval measurement parameters did not show any significant differences. Conclusions: Thrombectomy additional to PPCI helps more effective reperfusion at the microvascular level and provides additional prognostic information.

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“…[20] Previous studies have suggested increased QTd in patients with ischemic CAD. [21,22] We could not document any relationship between QTd and EAT in the present study. There may be two explanations for this finding.…”

Section: Discussioncontrasting

confidence: 74%

The relationship between epicardial adipose tissue and P wave and QT dispersions

Çiçek¹

2015

Arch Turk Soc Cardiol

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Effects of ischemia on QT dispersion during spontaneous anginal episodes

Cited by 13 publications

References 36 publications

Early Reduction of QT Dispersion after Primary Percutaneous Intervention in ST-Segment Elevation Acute Myocardial Infarction

Early Reduction of QT Dispersion after Primary Percutaneous Intervention in ST-Segment Elevation Acute Myocardial Infarction

The Comparison in Reduction of QT Dispersion After Primary Percutaneous Coronary Intervention According to Existence of Thrombectomy in ST‐Segment Elevation Myocardial Infarction

The relationship between epicardial adipose tissue and P wave and QT dispersions

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