Relationship between impaired repolarization parameters and poor cardiovascular clinical outcomes in patients with potentially serious coronary artery anomalies

Abstract

Background Congenital coronary artery anomalies (CCAAs) have the potential for life-threatening complications, including malignant ventricular arrhythmias and sudden cardiac death (SCD). In this study, we aimed to evaluate the relationship between impaired repolarization parameters and poor cardiovascular clinical outcomes in patients with potentially serious CCAAs.Methods This retrospective study included 85 potentially serious CCAA patients (mean age: 54.7 ± 13.6 years; male:44) who were diagnosed with conventional and coronary computed tomography angiography (CCTA). All patients underwent transthoracic echocardiography and 12-lead surface electrocardiography. Cardiac events were defined as sustained ventricular tachycardia or fibrillation, syncope, cardiac arrest and SCD. ResultsThe presence of interarterial course (IAC) was confirmed by CCTA in 37 (43.5%) patients. During a median follow-up time of 24 (18-50) months, a total of 11 (12.9%) patients experienced cardiac events. The presence of IAC was significantly more frequent and Tp-e interval, Tp-e/QTc ratio and frontal QRS/T angle (fQRSTa) were significantly greater in patients with poor clinical outcomes. Moreover, the presence of IAC, high Tp-e/ QTc ratio and high fQRSTa were found to be independent predictors of poor clinical outcomes and decreased longterm cardiac event-free survival in these patients. A net reclassification index was +1.0 for the Tp-e/QTc ratio and +1.3 for fQRSTa which were confirmable for additional predictability of these repolarization abnormalities Conclusion Impaired repolarization parameters, including wider fQRSTa, prolonged Tp-e interval, and increased Tp-e/QTc ratio, and IAC may be associated with poor cardiovascular clinical outcomes in potentially serious CCAA patients. Coron Artery Dis 33: e27-e36

Clinical Value of Tp-e/QTc Ratio in Patients Undergoing Coronary Angiography for Acute Coronary Syndrome

“…In recent years, it has been reported that these simple ECG parameters predict fatal ventricular arrhythmias in several cardiovascular diseases. 2 , 3 Particularly its association with ventricular tachycardia and fibrillation and sudden cardiac death has been reported. 3 The readers may wonder if the 421 acute coronary syndrome patients in the study had any adverse clinical outcomes, such as ventricular arrhythmias or sudden cardiac death.…”