Usefulness of QT dispersion immediately after exercise as an indicator of coronary stenosis independent of gender or exercise-induced ST-segment depression

Koide, Yasushi; Yotsukura, Masayuki; Yoshino, Hideaki; Ishikawa, Kinya

doi:10.1016/s0002-9149(00)01233-9

Cited by 17 publications

(10 citation statements)

References 30 publications

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“…However, measurements in our study are based on long individual experience [1,2]. QT dispersion immediately after exercise was reported to be useful for detecting significant coronary artery disease in patients who do not have exercise-induced chest pain or significant ST-segment depression and this is independent of the patient's sex [13,14]. Stress QT dispersion of >60 ms had a sensitivity of 70% and a specificity of 95% for the diagnosis of significant coronary artery disease (CAD) (ST-segment depression !…”

Section: Discussionmentioning

confidence: 99%

QT dispersion in comparison to Tl-201-SPECT for detection of myocardial ischaemia

Schmidt

Schneider

Theissen

et al. 2006

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 99%

QT dispersion in comparison to Tl-201-SPECT for detection of myocardial ischaemia

Schmidt

Schneider

Theissen

et al. 2006

International Journal of Cardiology

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“…Recently, several studies reported that QT dispersion after exercise was a more powerful predictor of coronary artery disease than QT dispersion at rest. 18,19) Koide, et al reported that QT dispersion immediately after exercise was a clinically useful indicator of significant coronary stenosis independent of gender or the presence or absence of exercise-induced significant ST-segment depression. 18) They found that QT dispersion immediately after exercise was significantly more sensitive in men and significantly more specific in women than exercise-induced significant ST-segment depression as an indicator of significant coronary stenosis.…”

Section: Discussionmentioning

confidence: 99%

QT Dispersion in Patients with Polycystic Ovary Syndrome.

et al. 2002

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SUMMARYCardiac risk factors are observed more frequently in patients with polycystic ovary syndrome (PCOS). On the other hand, increased QT dispersion, which is a risk factor for cardiac arrhythmias and sudden death, has not been investigated in this syndrome. In this study, we evaluated QT dispersion in PCOS patients without overt heart disease. Thirtysix consecutive women with PCOS (mean age 24±5 years) and 36 healthy women of similar ages (mean age 24±4 years) participated in this study. PCOS was diagnosed if there were polycystic ovaries by ultrasound (enlarged ovaries with ≥8 cysts 2-8 mm in diameter), oligoamenorrhea (intermenstrual interval >35 days), hirsutism (Ferriman-Gallwey score, ≥7) and elevated serum levels of testosterone (≥2.7 nmol/L). Electrocardiograms were recorded at a paper speed of 50 mm/s. QT intervals were manually measured by a cardiologist. All intervals were corrected for heart rate according to Bazett's formula: QTc interval=QT interval/square root of the RR interval. Mean values of body mass index, heart rate, and blood pressure were not significantly different between the two groups (P>0.05). No significant differences in QT intervals (maximum QT, minimum QT, QT dispersion, minimum corrected QT, maximum corrected QT, and corrected QT dispersion) were observed between the two groups (P>0.05). Our results suggest that the risk of ventricular arrhythmias or sudden cardiac death is not increased in PCOS patients. (Jpn Heart J 2002; 43: 487-493) Key words: Electrocardiography, Polycystic ovary syndrome, QT dispersion POLYCYSTIC ovary syndrome (PCOS) is a disorder of chronic anovulation, hyperandrogenism, hirsutism, obesity, subfertility, hyperlipidemia, and insulin resistance. Infertility is not the only important component of this syndrome, since the risks of cardiac disease and hypertension also increase in women with PCOS.1-3) Insulin resistance and hyperinsulinemia appear central to the pathophysiology of PCOS. Glucose intolerance, abnormally high fasting serum lipid concentrations, and high blood pressure are the three cardiac risk factors that have From the

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“…Based on the previously published studies we decided to choose the cutoff point for QT dispersion at rest and immediately after exercise as ≥60 ms [10,11,12, 14]. That value was also the optimum cutoff point identified from the receiver operating characteristic (ROC curve) as described by Hanley and McNeil [21].…”

Section: Resultsmentioning

confidence: 99%

“…The main problem is proper assessment of the QT dispersion cutoff point. Based on the previously published studies [10,11,12, 14,] we decided to choose the cutoff point for QT dispersion at rest and immediately after exercise as ≥60 ms; however, other authors used also the value of ≥50 ms [15]. We found that the QT dispersion cutoff value of ≥60 ms measured at rest allowed us to predict the presence of restenosis with 40% sensitivity and 98% specificity; however, the same value immediately after exercise allowed us to predict restenosis with 80% sensitivity and 95% specificity.…”

Section: Discussionmentioning

confidence: 99%

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QT Interval Dispersion as a New Marker of Restenosis after Percutaneous Transluminal Coronary Angioplasty of Isolated Single-Vessel Coronary Artery Stenosis

Grygier

Lesiak²,

Podżerek³

et al. 2006

Cardiology

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Background: There are no reliable non-invasive markers of restenosis after percutaneous transluminal coronary angioplasty (PTCA). The aim of our study was to measure changes in QT interval dispersion after PTCA and to determine whether restenosis subsequently affects QT interval dispersion. Methods and Results: Fifty-six consecutive patients – 41 men and 15 women (mean age: 56.2 ±8.3 years) – with isolated stenosis of the left anterior descending artery who underwent successful PTCA were studied. A symptom-limited treadmill exercise test was performed within 7 days after PTCA and then again before repeated angiography. Repeated coronary angiography revealed restenosis in 15 patients (26.8%) and no signs of significant stenosis in 41 patients (73.2%). QT interval dispersion in the group of patients with restenosis measured before exercise increased from baseline 34 ± 7 to 49 ± 15 ms after 6 months (p < 0.01) and QT interval dispersion measured immediately after exercise increased from baseline 38 ± 4 to 68 ± 21 ms after 6 months (p < 0.001). In contrast, patients without restenosis showed no significant changes in QT interval dispersion measured before (baseline: 34 ± 9 ms; after 6 months 33 ± 12 ms; p = NS) and immediately after exercise (baseline: 34 ± 12 ms; after 6 months: 33 ± 10; p = NS). When QT interval dispersion ≧60 ms (measured 6 months after PTCA procedure) was considered as a potential marker of restenosis, this indicator had very high sensitivity and specificity when measured immediately after exercise (80 and 95% respectively). Conclusions: QT interval dispersion significantly increases in the group of patients with documented restenosis and may be a simple, non-invasive marker of restenosis. However, further studies are needed to confirm this observation.

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Usefulness of QT dispersion immediately after exercise as an indicator of coronary stenosis independent of gender or exercise-induced ST-segment depression

Cited by 17 publications

References 30 publications

QT dispersion in comparison to Tl-201-SPECT for detection of myocardial ischaemia

QT dispersion in comparison to Tl-201-SPECT for detection of myocardial ischaemia

QT Dispersion in Patients with Polycystic Ovary Syndrome.

QT Interval Dispersion as a New Marker of Restenosis after Percutaneous Transluminal Coronary Angioplasty of Isolated Single-Vessel Coronary Artery Stenosis

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