Influence of Exercise on QT Dispersion in Ischemic Heart Disease.

Musha, Haruki; Kunishima, Tomoyuki; Awaya, Toru; Iwasaki, Tatsuya; Nagashima, Junzo; Nakamura, Toshika; Oohama, N; Ooba, Haruo; Arai, Satoshi; Takada, Hideomi; Murayama, Masahiro

doi:10.1536/ihj.38.219

Cited by 16 publications

(11 citation statements)

References 18 publications

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“…A 12-lead ECG is currently used as a complementary tool to diagnose ischemia during dobutamine stress ECG but it has not been conclusively shown that deviations in the ST segment are reliable markers for ischemia [10,11]. As noted in this study, there are a number of false-negative and false-positive results obtained during exercise or pharmacological stress testing if ST-T changes on the ECG are considered to document an ischemic response, especially in women.…”

Section: Discussionmentioning

confidence: 79%

“…Thus, increase in QTc interval, as a marker of ischemia, is a simple, useful parameter that can improve the sensitivity and specificity of dobutamine stress tests using an ECG alone. A number of studies have evaluated the role of QTc interval and QT dispersion in myocardial ischemia and as a marker of arrhythmic events [10][11][12][13]. We along with others have shown an association between QT prolongation and ischemia during exercise stress testing [5,11].…”

Section: Discussionmentioning

confidence: 83%

“…A correlation between degree of QT dispersion variability and extent of coronary artery disease has been proposed in some studies [10]. Hence abnormal mechanical events may result in alterations of electrophysiological properties and thus reflect as changes in QTc interval and QT dispersion [10,11,15].…”

Section: Discussionmentioning

confidence: 98%

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Prolongation of the QT-corrected interval during dobutamine stress echocardiography: a marker for ischemia

T¹,

Pendyala²,

López‐Candales³

2003

Coronary Artery Disease

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These results suggest that the development of new wall motion abnormalities suggestive of ischemia during DSE is associated with prolongation of the QTc interval and delayed heart rate early in the recovery period. These two parameters should be further studied not only as additional markers in the identification of ischemia in patients referred for DSE but also to assess their potential significance during short- and long-term follow-up.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 83%

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Prolongation of the QT-corrected interval during dobutamine stress echocardiography: a marker for ischemia

T¹,

Pendyala²,

López‐Candales³

2003

Coronary Artery Disease

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“…In previous reports, the time at which QTD was measured in the exercise ECG varied from immediately after exercise 5,13 to 5 min after exercise, 14 and there has not been general agreement concerning the optimal determination point. In the present study, we did not measure QTD during exercise because of the presence of too many artefacts on the ECG.…”

Section: Discussionmentioning

confidence: 98%

Significance of Exercise QT Dispersion in Patients With Coronary Artery Disease Who do not Have Exercise-Induced Ischemic ST-Segment Changes

Yoshimura¹,

Matsumoto²,

Watanabe³

et al. 1999

Jpn Circ J

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xercise electrocardiography is the most widely used method for the diagnosis and assessment of the severity of coronary artery disease (CAD). However, the poor sensitivity and the poor predictive value of ST-segment depression have limited the usefulness of the exercise electrocardiogram (ECG) in the detection and evaluation of CAD. 1 ST-segment depression alone has, as a diagnostic means, a sensitivity of 68% and a specificity of 77%. 2 Recent clinical studies have indicated that QT dispersion (QTD), defined as the difference between maximal and minimal QT intervals on a 12-lead ECG, reflects heterogeneity in the duration of myocardial repolarization and is associated with regional ischemia and wall motion abnormalities. 3,4 In the patients who present an exercise-induced ST-segment depression on the ECG, false-positive results are reportedly reduced by measuring the QTD as an additional condition for a positive test. 5 However, in patients with CAD who do not present an ST-segment depression on the exercise ECG, it is not well known whether measuring the QTD during exercise and recovery is useful for the diagnosis and evaluation of CAD. Moreover, the time at which QTD is measured on the ECG recorded during exercise and recovery is variable, and there is no general agreement concerning the optimal time of measurement.We investigated the time-course of QTD and heart-rateJapanese Circulation Journal Vol.63, July 1999corrected QTD (QTcD) on exercise ECGs and assessed the diagnostic value of QTD in patients with CAD who do not present an ST-segment depression during exercise or recovery. Methods SubjectsFifty subjects who underwent treadmill stress tests and coronary angiography because of effort-related chest pain for more than a few minutes were enrolled in this study. All of them showed negative exercise stress test results, defined as standard ST-segment depression criteria. None of them were taking antiarrhythmic or antianginal drugs. Subjects who had suffered a myocardial infarction, had left ventricular hypertrophy, atrial fibrillation, or presented bundle branch block were excluded. Approval was obtained from Saiseikai Hiroshima Hospital Ethics Committee, and written informed consent was obtained from each subject. Twenty-five patients who had CAD, defined as having a history of typical chest pain for more than a few minutes and responsive to nitrate, and having angiographic evidence of ≥50% luminal diameter narrowing of a major epicardial artery in any projection, were studied. The most stenotic coronary artery was the left anterior descending in 12, the left circumflex in 5, and the right coronary artery in 8 patients. Eleven patients had multi-vessel disease (2-vessel, 6; 3-vessel, 5). The control group consisted of 25 subjects with no evidence of significant coronary artery stenosis or vasospasm. Coronary AngiographyAll participants underwent coronary angiography for the Jpn Circ J 1999; 63: 517 -521 (Received February 8, 1999; revised manuscript received March 17, 1999; accepted April 2, 1999 The poor...

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“…[1][2][3] However, the dispersion of ventricular repolarization may depend on the time after myocardial infarction, the location and size of the infarct, the presence or absence of residual ischemia, and the patient's drug therapy. The effects of time after infarction, 4) residual ischemia, [5][6][7] and various drugs 8,9) have already been studied. Regarding the infarct location and size, Raev, et al 10) and Mirvis, et al 11) have reported on the QT inter-val, while Moreno, et al 12) studied QT dispersion after acute myocardial infarction.…”

mentioning

confidence: 99%

Relationship between Infarction Location and Size to QT Dispersion in Patients with Chronic Myocardial Infarction.

et al. 2002

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SUMMARYThe relationship between the location and size of an infarction and QT dispersion was investigated in 84 Japanese patients with chronic myocardial infarction (54 with anteroseptal infarction and 30 with inferior infarction). The control group consisted of 23 subjects without ischemic heart disease (13 normal subjects and 10 hypertensive patients). Corrected QT dispersion (maximum corrected QT interval minus minimum corrected QT interval: QTc dispersion), was significantly larger in the anterior infarction group than in the control group (69.9±21.5 msec vs 53.0±17.6 msec), while the inferior infarction group showed no significant difference from control subjects. QTc dispersion was significantly greater in the patients with large anterior infarcts than in those with small anterior infarcts (80.5±20.5 msec vs 61.9±18.8 msec). In patients with chronic myocardial infarction, QT dispersion is influenced by the infarct location and size. Accordingly, interpretation of QT dispersion data should take these factors into consideration. (Jpn Heart J 2002; 43: 455-461)

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Influence of Exercise on QT Dispersion in Ischemic Heart Disease.

Cited by 16 publications

References 18 publications

Prolongation of the QT-corrected interval during dobutamine stress echocardiography: a marker for ischemia

Prolongation of the QT-corrected interval during dobutamine stress echocardiography: a marker for ischemia

Significance of Exercise QT Dispersion in Patients With Coronary Artery Disease Who do not Have Exercise-Induced Ischemic ST-Segment Changes

Relationship between Infarction Location and Size to QT Dispersion in Patients with Chronic Myocardial Infarction.

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