Tpeak-to-Tend/QT is an independent predictor of early ventricular arrhythmias and arrhythmic death in anterior ST elevation myocardial infarction patients

Mugnai, Giacomo; Benfari, Giovanni; Fede, Alfredo; Rossi, Andrea; Chierchia, Gian Battista; Vassanelli, Francesca; Menegatti, G.; Ribichini, Flavio

doi:10.1177/2048872615598616

Cited by 25 publications

(14 citation statements)

References 26 publications

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“…Spatial variability in the QT intervals of ECGs (QT dispersion) has been shown to reflect variability of ventricular repolarization dispersion and was a marker of arrhythmogenic potential in variant angina and STEMI. [ 14 , 15 ] In this investigation, QT dispersion was increased by myocardial infarction, and there was greater QT dispersion in the ISTR group than in the CSTR group. The existence of QT dispersion reflected inhomogeneity in ventricular repolarization in infarcted region and noninfarcted region.…”

Section: Discussionmentioning

confidence: 58%

Tpeak-Tend/QT interval predicts ST-segment resolution and major adverse cardiac events in acute ST-segment elevation myocardial infarction patients undergoing percutaneous coronary intervention

Wang

Zhang²,

Gao³

et al. 2018

Medicine

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Elevated ST-segment and increased Tpeak-Tend interval (Tp-e) were prognostic predictors in major adverse cardiac events (MACEs) in ST-segment elevation myocardial infarction (STEMI). The electrophysiologic relationship between them during percutaneous coronary intervention (PCI) needs to elucidate.Patients with STEMI admitted to hospital were prospectively evaluated. ST-segment resolution (STR) (defined as ≥50% reduction as the complete-STR [CSTR] group, <50% as incomplete-STR [ISTR] group), Tp-e interval, and ratio of Tp-e to QT interval (Tp-e/QT) were measured, calculated and analyzed with MACEs.Tp-ec interval (corrected Tp-e interval, P < .001) and Tp-e/QT ratio (P < .001) were significantly increased by myocardial infarction and partly recovered post-PCI. Patients with ISTR showed more increased Tp-ec interval (P < .001) and Tp-e/QT ratio (P < .001) than those in CSTR groups post-PCI. In multivariate analysis and receiver operating characteristic curves analysis, Tp-e/QT was an independent and strongest predictor for STR. STR and electrocardiogram parameters with a cutoff value for predicting STR showed prognostic value for MACE in STEMI in Kaplan–Meier survival analysis.Both STR and change of Tp-e parameters were not only predictors of arrhythmia, but also prognostic factors of MACE in patients with STEMI after PCI.

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Section: Discussionmentioning

confidence: 58%

Tpeak-Tend/QT interval predicts ST-segment resolution and major adverse cardiac events in acute ST-segment elevation myocardial infarction patients undergoing percutaneous coronary intervention

Wang

Zhang²,

Gao³

et al. 2018

Medicine

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“…Our search strategy returned 2442 potentially relevant items (Figure ). Of these, 22 studies (5538 patients, mean age: 60 years old, 76.1% males) were finally included for further analysis. Seventeen studies included HF patients (3262 patients with ischemic heart disease, 862 patients with nonischemic heart disease, mean age: 62.8 years old, males: 76.3%, mean LVEF: 38.4%) according to the predefined criteria while 13 studies included only CHD patients.…”

Section: Resultsmentioning

confidence: 99%

Association of QT dispersion with mortality and arrhythmic events—A meta‐analysis of observational studies

Bazoukis

Yeung

et al. 2019

Journal of Arrhythmia

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Background:The risk stratification of coronary heart disease (CHD) and/or heart failure (HF) patients with easily measured electrocardiographic markers is of clinical importance. The aim of this meta-analysis is to indicate whether increased QT dispersion (QTd) is associated with fatal and nonfatal outcomes in patients with CHD and/or HF. Methods:We systematically searched MEDLINE and Cochrane databases without restrictions until August 15, 2018 using the keyword "QT dispersion". Studies including data on the association between QTd and all-cause mortality, sudden cardiac death (SCD) or arrhythmic events in patients with HF and/or CHD were classified as eligible. Results:In the analysis including patients with CHD and/or HF, we found that QTd did not differ significantly in patients with SCD compared to no SCD patients while QTd was significantly greater in the group of all-cause mortality patients and in patients who experienced a sustained ventricular arrhythmia. Subgroup analysis showed that in myocardial infarction studies, QTd was significantly higher in patients with

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“…The sensitivity, specificity and negative predictive value for T p-e /QT ratio at >0.25 was84.21%, 58.49% and 96.88%. Mugnai et al 23 have found T p-e /QT ratio of 0.31 showed the best combined sensitivity and specificity (69.7% and 63.7%), respectively, along with negative predictive value of 92%. Shenthar et al 22 have found that T p-e /QT ratio<0.3 had a negative predictive value of 100%.…”

Section: Discussionmentioning

confidence: 98%

“…In the past years, some studies have shown T p-e /QT ratio as predictors of malignant ventricular arrhythmias in patients with ST-segment elevation myocardial infarction (STEMI) 21,22,23 .…”

mentioning

confidence: 99%

Association of Increased Tpeak-to-end/QT ratio with Malignant Ventricular Arrhythmias in Acute Anterior ST-Segment Elevation Myocardial Infarction

et al. 2017

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Background: Increased Tpeak-to-end/QT ratio on 12 lead surface electrocardiogram (ECG) has been shown to be the predictor of arrhythmogenesis in various cardiac disorders. There is limited data regarding association of these two parameters with malignant ventricular arrhythmias (MVA) in acute ST-segment elevation myocardial infarction (STEMI) patients. Objectives: This study was conducted to evaluate association of increased Tpeak-to-end/QT ratio with MVAs in acute anterior STEMI. Methods: 178 patients with acute anterior STEMI admitted within 12 hours of onset of chest pain into the Coronary Care Unit, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, were enrolled from November 2015 to October 2016. Tpeak-to-end/QT ratio was calculated from surface ECG at the time of admission. The patients were divided into two groups, group I and II according to normal (?0.25) and increased Tpeak-to-end/QT ratio (>0.25). Each group was monitored for development of MVAs for the first 48 hours of myocardial infarction. Results: MVAs were significantly higher in group II than group I (19.5% vs 3.1%, p<0.001). Multivariate regression analysis showed significant association (p=0.002) of increased Tpeak-to-end/QT ratio with MVAs (Odds Ratio, 3.845).Receiver operating characteristic (ROC) curve analysis showed that Tpeak-to-end/QT ratio <0.25 had a negative predictive value of 96.88% for the prediction of MVAs. Conclusion: The study demonstrated that there was significant association of increased Tpeak-to-end/QT ratio with malignant ventricular arrhythmias in acute anterior STEMI patients. Thus analysis of 12 lead surface ECG on admission may help predict malignant ventricular arrhythmias in the first 48 hours of acute anterior myocardial infarction and close monitoring with prompt management may be ensured in high risk patients.Bangladesh Heart Journal 2017; 32(1) : 10-17

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Tpeak-to-Tend/QT is an independent predictor of early ventricular arrhythmias and arrhythmic death in anterior ST elevation myocardial infarction patients

Cited by 25 publications

References 26 publications

Tpeak-Tend/QT interval predicts ST-segment resolution and major adverse cardiac events in acute ST-segment elevation myocardial infarction patients undergoing percutaneous coronary intervention

Tpeak-Tend/QT interval predicts ST-segment resolution and major adverse cardiac events in acute ST-segment elevation myocardial infarction patients undergoing percutaneous coronary intervention

Association of QT dispersion with mortality and arrhythmic events—A meta‐analysis of observational studies

Association of Increased Tpeak-to-end/QT ratio with Malignant Ventricular Arrhythmias in Acute Anterior ST-Segment Elevation Myocardial Infarction

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