The Relationship between P & QT Dispersions and Presence & Severity of Stable Coronary Artery Disease

Abstract

Background and ObjectivesThe study aimed to evaluate the correlation between electrocardiographic (ECG) parameters and presence and extent of coronary artery disease (CAD) to indicate the usefulness of these parameters as predictors of severity in patients with stable CAD.Subjects and MethodsTwo hundred fifty patients, without a history of any cardiovascular event were included in the study. The ECG parameters were measured manually by a cardiologist before coronary angiography. The patients were allocated into five groups: those with normal coronary arteries (Group 1), non-critical coronary lesions (Group 2), one, two and three vessel disease (Group 3, Group 4 and Group 5, respectively.ResultsGroup 1 had the lowest P wave dispersion (PWD) and P wave (Pmax), QT interval (QTmax), QT dispersion (QTd), corrected QT dispersion (QTcd) and QT dispersion ratio (QTdR), while the patients in group 5 had the highest values of these parameters. Gensini score and QTmax, QTd, QTcmax, QTcd, QTdR, Pmax, and PWD were positively correlated. QTdR was the best ECG parameter to differentiate group 1 and 2 from groups with significant stenosis (groups 3, 4, and 5) (area under curve [AUC] 0.846). QTdR was the best ECG parameter to detect coronary arterial narrowing lesser than 50% and greater than 50%, respectively (AUC 0.858).ConclusionPresence and severity of CAD can be determined by using ECG in patients with stable CAD and normal left ventricular function.

Are P Wave and QT Dispersions Related to Severe Peripheral Artery Disease?

“…Given the systemic nature of atherosclerosis, there is a high prevalence of CAD in the patient population scheduled for PABS. Recent studies have shown that coronary angiography and revascularization as needed prevent postoperative cardiac complications during and after noncardiac surgery [ 8 , 9 ]. In daily practice, it is a common approach for surgeons to monitor patients undergoing PABS for underlying obstructive CAD when they have a history of CAD or signs of ischemia on ECG or echocardiography.…”

“…QTD also indicates heterogeneity of ventricular repolarization. Repolarization impairments caused by ischemia and regional fibrosis due to chronic ischemia may be the reasons for the increased QTD detected in patients with CoAD [ 9 ]. QTD may increase the incidence of sudden death and ventricular tachycardia in various cardiovascular conditions and noncardiac diseases [ 7 , 14 ].…”

“…Previously conducted studies demonstrated that PWD has a predictive value for PAF in patients with different clinical conditions [ 6 , 7 ]. QTD, on the other hand, appears to increase in patients with acute myocardial infarction and significant stable coronary stenosis [ 8 , 9 ].…”

Korelasi Keparahan Penyakit Jantung Koroner dengan Dispersi QT pada Pasien Obstructive Sleep Apnea (OSA)

“…Salah satu pemeriksaan noninvasif yang mudah dilakukan untuk penegakkan diagnosis, penentuan prognosis, dan risiko kardiovaskular PJK adalah pengukuran interval QT (IQT) pada elektrokardiogram (EKG). [7][8][9] Pemanjangan IQT merupakan penanda aritmia ventrikel dan KJM. Perbedaan antara interval QT terpanjang dengan terpendek dikenal sebagai dispersi QT (QTd).…”

“…Perbedaan antara interval QT terpanjang dengan terpendek dikenal sebagai dispersi QT (QTd). [8][9][10][11] Dispersi QT merupakan ukuran heterogenitas repolarisasi miokardial yang mampu memprediksi kejadian aritmia ventrikular yang menjadi penyebab KJM. 4,11,12 Beberapa studi juga menunjukkan pemanjangan QTd yang meningkat pada pasien dengan penyakit jantung koroner.…”