The role of baseline and post‐procedural frontal plane <scp>QRS</scp>‐T angles for cardiac risk assessment in patients with acute <scp>STEMI</scp>

Colluoglu, Tugce; Tanriverdi, Zulkif; Ünal, Barış; Özcan, Emin Evren; Dursun, Hüseyin; Kaya, Derya

doi:10.1111/anec.12558

Cited by 31 publications

(34 citation statements)

References 22 publications

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“…In previous studies, QRS and T axis changes have been found to be related with transient ischemic episodes in patients with coronary artery occlusion (6), and also the relationship between multivessel CAD and wide QRSTa was demonstrated by Colluoglu et al (13). It supports the QRSTa as an important predictor of ischemia.…”

Section: Discussionmentioning

confidence: 72%

Frontal QRS-T angle is related wtih hemodynamic significance of coronary artery stenosis in patients with single vessel disease

Kahraman¹

2019

Anatol J Cardiol

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Frontal QRS-T angle is related with hemodynamic significance of coronary artery stenosis in patients with single vessel disease Objective: Fractional flow reserve (FFR) measurement is used to decide the hemodynamic significance of coronary artery lesion. QRS-T angle (QRSTa) is a novel marker of myocardial repolarization abnormality and is affected by obstructive coronary artery disease. The aim of the present study was to evaluate the association between QRSTa and coronary FFR measurement in patients with isolated left anterior descending (LAD) artery stenosis.Methods: A total of 197 patients undergoing FFR measurement for isolated LAD artery stenosis were retrospectively enrolled in the present study. According to FFR value, patients were divided into two groups as 139 patients with normal FFR (>0.80, group 1) and 58 patients with low FFR (≤0.80, group 2). A 12-lead surface electrocardiography of all subjects that had been recorded before performing coronary angiography was evaluated to measure QRSTa, as well as baseline demographic and clinical variables. Results: The mean age of group 2 was significantly higher than that of group 1 (61±11 and 64±11, p=0.044). While there were no differences in heart rate, QRS duration, and corrected QT interval between the two groups, and 379 (367-410), p=0.045] and frontal QRSTa [59 (10-120) and 86 (22-132), p<0.001] were higher in group 2. QT interval [odds ratio (OR)=1.046, 95% confidence interval (CI)=1.010-1.084, p=0.012] and frontal QRSTa (OR=1.025, 95% CI=1.010-1.041, p=0.001) were found to be independent predictors of low FFR value in multivariate logistic regression analysis.Conclusion: In the present study, FFR measurement was demonstrated to be correlated with wide QRSTa as a noninvasive and easy method. Thus, we suggest that the results of FFR measurement as an invasive modality can be previously predicted with a simple electrocardiographic evaluation, such as QRSTa. (Anatol J Cardiol 2019; 22: 194-201) ABSTRACT Kahraman et al. Coronary atherosclerosis related fQRS-T angle Anatol

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Section: Discussionmentioning

confidence: 72%

Frontal QRS-T angle is related wtih hemodynamic significance of coronary artery stenosis in patients with single vessel disease

Kahraman¹

2019

Anatol J Cardiol

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“…Previous studies have suggested the clinical importance of the frontal QRS-T angle in different populations. 7,[29][30][31][32][33] Also, it was reported that an increased frontal QRS-T angle was associated with an increased risk of arrhythmic death. 34 In this study, we also evaluated the frontal QRS-T angle and found that it was significantly increased by propofol.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have also shown the prognostic value of the frontal QRS-T angle in predicting cardiovascular arrhythmias. 7 Unlike the QT and Tp-e intervals, the frontal QRS-T angle can be calculated more easily from 12-lead surface electrocardiograms (ECGs).…”

Section: What Is K Nown and Objec Tivementioning

confidence: 99%

The effect of propofol on frontal QRS‐T angle in patients undergoing elective colonoscopy procedure

et al. 2019

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What is known and objective: Propofol is a most commonly used anaesthetic drug for conscious sedation in outpatient procedures. Previous studies have shown that propofol may affect ventricular repolarization based on QT and Tp-e intervals. Frontal QRS-T angle is a marker of ventricular depolarization and repolarization difference. However, there is no study investigating the effect of propofol on frontal QRS-T angle. In this study, we aimed to investigate the effect of propofol on frontal QRS-T angle in patients undergoing colonoscopy procedure. Method: A total of 56 patients (53.5% females) who underwent colonoscopy procedure were included in this study. All patients underwent 12-lead surface electrocardiograms (ECGs) just before colonoscopy and 15 minutes after colonoscopy. QT interval, QTc interval, Tp-e interval, Tp-e/QT, Tp-e/QTc and frontal QRS-T angle were calculated from 12-lead ECGs. Results and discussion: The frontal QRS-T angle was significantly increased 15 minutes after colonoscopy compared to basal value (36.2 ± 24.3 vs. 29.5 ± 23.6, P = .003). In addition, repolarization parameters including QT, QTc and Tp-e intervals were significantly prolonged at 15 minutes after colonoscopy compared to basal value, except Tp-e/QT and Tp-e/QTc. Significant ventricular or supraventricular arrhythmias were not observed in any patient during the procedure. What is new and conclusion: In this study, we found that propofol administration increased the frontal QRS-T angle in patients undergoing colonoscopy procedure. Given that a prolonged frontal QRS-T angle is associated with ventricular arrhythmias, it may be safer to monitor those patients receiving propofol during colonoscopy procedures.

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“…27 In addition, it was shown that patients with baseline frontal QRSTa ≥95.6° had significantly higher frequency of 3-vessel disease compared to patients with baseline frontal QRSTa <95.6° in STEMI. 9 Moreover, it was also detected that proximal vessel disease was more frequently encountered in patients with baseline frontal QRSTa ≥95.6°. 9…”

Section: Laboratory Measurementsmentioning

confidence: 94%

“…7 Raposeiras-Roubin et al demonstrated that a wide frontal QRSTa (>90°) is a good discriminator of long-term mortality in patients with depressed ejection fraction (EF) after an ACS, 8 while in another study, it has been demonstrated that the postprocedural frontal QRSTa can predict in-hospital mortality and thrombolytic therapy failure. 9 Investigation on the association of total bilirubin levels with frontal QRSTa, a predictor of general and cardiac mortality, may be beneficial in revealing this issue after PCI in patients with ACS. In the present study, we intended to demonstrate the association between serum bilirubin levels and change of frontal QRSTa after PCI in ACS patients.…”

Section: Introductionmentioning

confidence: 99%

Serum Bilirubin Level Predicts Frontal QRS-T Angle Change in Patients with Acute Coronary Syndrome

Erdoğan

Yenerçağ

Durmuş

et al. 2020

Journal of Cardiovascular Emergencies

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Introduction: The predictive role of serum bilirubin levels on the alteration of total ischemic burden expressed via frontal QRS-T angle change has never been studied in patients with acute coronary syndrome (ACS). In this study, we aimed to investigate the relationship between serum bilirubin levels and frontal QRS-T angle change after percutaneous coronary intervention (PCI) in ACS patients.Methods: Frontal QRS-T angle change was accepted as positive or negative according to whether the value of the baseline frontal QRS-T angle minus the post PCI frontal QRS-T angle is positive or negative. A total of 314 consecutive patients with ACS who underwent PCI were divided into two groups based on their negative frontal QRS-T angle change (n = 152 patients) and positive frontal QRS-T angle change (n = 162 patients).Results: Multivariate logistic regression analysis showed that the C-reactive protein (CRP) to albumin ratio (CAR) (Odds ratio [OR]: 0.519, 95% CI: 0.373–0.724, p <0.001), total bilirubin (OR: 3.687, 95% CI: 1.151–8.095, p = 0.03), and low-density lipoprotein (LDL) (OR: 0.985, 95% CI: 0.970–1.000, p = 0.04) were independent predictors of positive QRS-T angle change. In receiver operating characteristics curve analysis, a cut-off value of 0.59 total bilirubin had a 69% sensitivity and a 65% specificity (area under curve: 0.739, p <0.001) for the prediction of positive QRS-T angle change.Conclusion: In ACS patients, serum total bilirubin has been found to be a useful decision-making tool to predict positive frontal QRS-T angle change as a sign of reduced total ischemic burden, to assess early invasive strategy independently from other study parameters.

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The role of baseline and post‐procedural frontal plane QRS‐T angles for cardiac risk assessment in patients with acute STEMI

Abstract: f(QRS-T) angle may be used as a beneficial tool for determining high risk patients in acute STEMI. Unlike previous studies, we showed for the first time that that post-procedural f(QRS-T) can predict in-hospital mortality and TT failure.

Cited by 31 publications

References 22 publications

Frontal QRS-T angle is related wtih hemodynamic significance of coronary artery stenosis in patients with single vessel disease

Frontal QRS-T angle is related wtih hemodynamic significance of coronary artery stenosis in patients with single vessel disease

The effect of propofol on frontal QRS‐T angle in patients undergoing elective colonoscopy procedure

Serum Bilirubin Level Predicts Frontal QRS-T Angle Change in Patients with Acute Coronary Syndrome

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