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

Abstract

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.

Hafif Akut Miyokarditli Genç Hastalarda İnteratriyal Blok ve Ventriküler Repolarizasyon Parametreleri

“…12,13 An increase or prolongation in the Tp-e interval or Tp-e/QT ratio is considered an index of arrhythmogenesis in all cases of long, normal, or short QT intervals, or in acquired or congenital channelopathies. 14 Although Uçar et al found the Tp -e interval or Tp-e/QT ratio to be significantly higher in the group of acute myocarditis patients compared to the control group, it should be noted that the control group in their study is consisted of completely healthy volunteers. The normal value of the Tp-e/QT ratio is around 0.192 ± 0.35.…”

ST-segment elevation predicts the occurrence of malignant ventricular arrhythmia events in patients with acute ST-segment elevation myocardial infarction

“…Because variant angina has the characteristic ischemia that can be completely reversed, it can be used as a model to study the relationship between STE and MVAEs. Moreover, our study showed that in patients with STEMI undergoing primary percutaneous coronary intervention (PCI), the duration of ST-segment resolution (STR) can predict malignant arrhythmia and long-term prognosis, and STE is related to the electrophysiological mechanism of the prolonged Tp-e interval [8]. Other studies have suggested that a prolonged Tp-e interval and elevated ST segment amplitude are independent risk factors for reperfusion VF in unselected patients with STEMI [9,10].…”

“…The presence of STR after both pharmacological and mechanical reperfusion therapy is highly predictive of infarct-related artery patency and the degree of effective microvasculature perfusion, which was inversely related to infarct size. Thus, STR was shown to be a significant independent predictor of major adverse cardiovascular events and target vessel revascularization in short-and long-term follow-ups [8,24]. STE represented the size of the acute infarcted myocardial area and the resulting potential gradient in the infarcted and non-infarcted regions leading to malignant arrhythmia.…”

Influence of aldosterone antagonists on markers of electrophysiological instability in patients with heart failure with mid-range ejection fraction after ST-segment elevation acute coronary syndrome in the short- and long-term periods

“…При анализе полученных результатов определено эффективное влияние эплеренона у пациентов, перенесших ОКСпST с ФВ ЛЖ =40-49%, после проведеной реперфузии миокарда на предикторы ВСС [5]. У пациентов с ХСНпST необходимо оценивать показатели дисперсий интервала QT и его отрезков и их корригированные по ЧСС значения [4].…”

“…Необходимо отметить, что использование как самого интервала QT и его дисперсии, так и его частей, имеет независимый от других сопутствующих факторов характер изменений при прогнозировании желудочковых та-хиаритмий при ОКСпST. Также доказана прогностическая значимость увеличения дисперсии интервала QT при ОКСпST и снижение ее после проведения ЧКВ [5,6].…”