Prolonged <scp>QT</scp> and myocardium recovery after primary <scp>PCI</scp>: a <scp>cMRI</scp> study

Ieva, Riccardo; Casavecchia, Graziapia; Gravina, Matteo; Totaro, Antonio; Ferraretti, Armando; Macarini, Luca; Brunetti, Natale Daniele

doi:10.1111/eci.12670

Cited by 6 publications

(7 citation statements)

References 16 publications

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“…This transient QTc-prolongation has been described to differ from the persistent QTc-prolongation associated with an increased risk of ventricular arrhythmia and poor outcome. 43,44 To the best of our knowledge, the phenomenon with transient long QTc as a marker for stunning has not been demonstrated in non-anterior STEMI specifically. Additional studies, ideally with serial assessment of ECGs, are needed to better understand the dynamic nature of QTc prolongation in anterior vs. non-anterior STEMI.…”

Section: Discussionmentioning

confidence: 96%

“…The lack of an association between QTc and LTVA or death in anterior STEMI is also consistent with previous data, because early and transient prolongation of QTc in anterior STEMI have been associated with stunned viable myocardium with increased potential for recovering cardiac function, smaller infarct size, and higher LVEF. This transient QTc‐prolongation has been described to differ from the persistent QTc‐prolongation associated with an increased risk of ventricular arrhythmia and poor outcome 43,44 . To the best of our knowledge, the phenomenon with transient long QTc as a marker for stunning has not been demonstrated in non‐anterior STEMI specifically.…”

Section: Discussionmentioning

confidence: 97%

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Risk of in‐hospital life‐threatening ventricular arrhythmia or death after ST‐elevation myocardial infarction vs. the Takotsubo syndrome

et al. 2021

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Aims The risk of life-threatening ventricular arrhythmias (LTVA) has been reported to be lower in Takotsubo syndrome (TS) compared with ST-elevation myocardial infarction (STEMI). However, the extent to which these differences relate to the fact that most patients with TS are women (who have a lower risk of LTVA) and a relatively larger proportion of patients with STEMI are men is incompletely understood. We aimed to investigate the risk of LTVA or death in sex-matched and age-matched patients with TS, anterior STEMI, and non-anterior STEMI. Methods and results We systematically reviewed the charts of all patients with TS who were treated at Sahlgrenska University Hospital (Gothenburg, Sweden) between 2008 and 2019. A total of 155 patients with confirmed TS (according to the European Society of Cardiology diagnostic criteria for TS) were sex-matched and age-matched 1:1:1 to patients with anterior and non-anterior STEMI. Baseline characteristics and in-hospital outcomes were recorded directly from the patient charts for all patients, and all admission electrocardiographs were analysed. The primary outcome was the composite of death or LTVA [defined as sustained ventricular tachycardia (>30 s) or ventricular fibrillation] within 72 h. The risk of LTVA or death within 72 h after admission was considerably lower in TS (2.6%) vs. anterior STEMI (14%; P = 0.002) and non-anterior STEMI (9.0%; P = 0.02), despite similar or greater risks of acute heart failure, and similar risks of cardiogenic shock. Compared with STEMI, TS was associated with a lower risk of sustained and non-sustained ventricular tachycardia and ventricular fibrillation. Conclusions In a predominantly female age-matched and sex-matched cohort of patients with TS, anterior STEMI, and non-anterior STEMI, the adjusted risk of in-hospital LTVA or death was considerably lower in TS compared with STEMI, despite similar or greater risk of acute heart failure and similar risk of cardiogenic shock.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 97%

Risk of in‐hospital life‐threatening ventricular arrhythmia or death after ST‐elevation myocardial infarction vs. the Takotsubo syndrome

et al. 2021

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“…A prolonged QT interval is also described after myocardial infarction and might be related to viable myocardium or systemic inflammation 15 , 16 .…”

Section: Discussionmentioning

confidence: 99%

Measurement of the QT interval using the Apple Watch

Spaccarotella

Migliarino

Mongiardo

et al. 2021

Sci Rep

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The inherited and acquired long QT is a risk marker for potential serious cardiac arrhythmias and sudden cardiac death. Smartwatches are becoming more popular and are increasingly used for monitoring human health. The present study aimed to assess the feasibility and reliability of evaluating the QT interval in lead I, lead II, and V2 lead using a commercially available Apple Watch. One hundred nineteen patients admitted to our Cardiology Division were studied. I, II, and V2 leads were obtained after recording a standard 12-lead ECG. Lead I was recorded with the smartwatch on the left wrist and the right index finger on the crown. Lead II was obtained with the smartwatch on the left lower abdomen and the right index finger on the crown. The V2 lead was recorded with the smartwatch in the fourth intercostal space left parasternal with the right index finger on the crown. There was agreement among the QT intervals of I, II, and V2 leads and the QT mean using the smartwatch and the standard ECG with Spearman’s correlations of 0.886; 0.881; 0.793; and 0.914 (p < 0.001), respectively. The reliability of the QTc measurements between standard and smartwatch ECG was also demonstrated with a Bland–Altman analysis using different formulas. These data show that a smartwatch can feasibly and reliably assess QT interval. These results could have an important clinical impact when frequent QT interval monitoring is required.

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“…Some authors have described this pattern of dynamic QT prolongation/T wave inversion as equal to Wellen’s ECG pattern [26] , which previously has been viewed as unfavorable because of the link to sub-occlusive LAD stenosis [27] . However, later studies have suggested transient QT prolongation/T wave inversion as a marker of stunned viable myocardium in AMI patients recovering after reperfusion [28] , [29] . Wellen’s ECG pattern per se has been attributed to myocardial edema [26] , and CMR studies have shown myocardial edema in both STEMI and TTS.…”

Section: Discussionmentioning

confidence: 99%

Temporal electrocardiographic changes in anterior ST elevation myocardial infarction versus the Takotsubo syndrome

Zeijlon¹,

Jha²,

Le³

et al. 2023

IJC Heart & Vasculature

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Prolonged QT and myocardium recovery after primary PCI: a cMRI study

Abstract: Viable myocardium recovering after primary angioplasty in STEMI may be predicted by the presence of increased QTc values in ischaemic areas in comparison with nonischaemic areas.

Cited by 6 publications

References 16 publications

Risk of in‐hospital life‐threatening ventricular arrhythmia or death after ST‐elevation myocardial infarction vs. the Takotsubo syndrome

Risk of in‐hospital life‐threatening ventricular arrhythmia or death after ST‐elevation myocardial infarction vs. the Takotsubo syndrome

Measurement of the QT interval using the Apple Watch

Temporal electrocardiographic changes in anterior ST elevation myocardial infarction versus the Takotsubo syndrome

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