Value of QT dispersion in the interpretation of treadmill exercise electrocardiograms of patients without exercise-induced chest pain or ST-segment depression

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

doi:10.1016/s0002-9149(00)00702-5

Cited by 17 publications

(16 citation statements)

References 28 publications

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“…At the same time, the diagnostic accuracy of ischemia with standard exercise treadmill testing criteria is not ideal, and it is known that patients with an MB who do not have significant ST-segment depressions may still have myocardial ischemia (Gawor et al, 2011). We suspect that even patients without significant ST-segment changes have abnormal repolarization and an increased QTd due to focal ischemia (Koide, Yotsukura, Yoshino, & Ishikawa, 2000). In the future, the development of formal cutoff values for QTd and ΔQTd may be helpful.…”

Section: Discussionmentioning

confidence: 99%

Myocardial bridging is associated with exercise‐induced ventricular arrhythmia and increases in QT dispersion

Nishikii-Tachibana

Pargaonkar

Schnittger

et al. 2017

Noninvasive Electrocardiol

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BackgroundA myocardial bridge (MB) has been associated with ventricular arrhythmia and sudden death during exercise. QT dispersion (QTd) is a measure of abnormal repolarization and may predict ventricular arrhythmia. We investigated the frequency of ventricular arrhythmias during exercise and the QTd at rest and after exercise, in patients with an MB compared to a normal cohort.MethodsWe studied the rest and stress ECG tracings of patients with an MB suspected by focal septal buckling on exercise echocardiography (EE) (Echo‐MB group, N = 510), those with an MB confirmed by another examination (MB group, N = 110), and healthy controls (Control group, N = 198).ResultsThe frequency of exercise‐induced premature ventricular contractions (PVCs) was significantly higher in the Echo‐MB and MB groups compared with the Control group (both p < .001). In all, 25 patients (4.9%) in the Echo‐MB group, seven patients (6.4%) in the MB group and no patients in the Control group had exercise‐induced non‐sustained ventricular tachycardia (NSVT). There was no difference in the baseline QTd between the groups. In the Echo‐MB and MB groups, QTd postexercise increased significantly when compared with baseline (both p < .001). Patients with NSVT had a higher frequency of male gender and an even greater increase in QTd with exercise compared with the non‐NSVT group.DiscussionThere is an increased frequency of exercise‐induced PVCs and NSVT in patients with MBs. Exercise significantly increases QTd in MB patients, with an even greater increase in QTd in MB patients with NSVT. Exercise in MB patients results in ventricular arrhythmias and abnormalities in repolarization.

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Section: Discussionmentioning

confidence: 99%

Myocardial bridging is associated with exercise‐induced ventricular arrhythmia and increases in QT dispersion

Nishikii-Tachibana

Pargaonkar

Schnittger

et al. 2017

Noninvasive Electrocardiol

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“…11 Some new criteria lessening this limitation of the exercise test have been reported. 1,12,20,21 Among these, the Duke treadmill score, based on the scoring of classical ST-segment deviation, exercise duration, and exercise-induced chest pain, has been reported to increase the diagnostic value of the exercise test in women. 1 In studies evaluating the relationship between QTD and transient myocardial ischemia in patients without previous myocardial infarction, it was shown that QTD increased in response to the transient ischemia.…”

Section: Discussionmentioning

confidence: 99%

“…1 In studies evaluating the relationship between QTD and transient myocardial ischemia in patients without previous myocardial infarction, it was shown that QTD increased in response to the transient ischemia. 8,9,11,12 Likewise, whether QTD measurements indicating increased inhomogeneity of the ventricular repolarization phase due to myocardial ischemia have increased the diagnostic value of the exercise test in women in whom the criteria of ST-segment changes are not enough for a diagnosis has not been well investigated. In a unique study 11 evaluating in detail the QTD and QTcD values measured at peak exercise in women, higher diagnostic values than those for ST-segment depression have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…The increase in QTD due to the effect of CAD is thought to be parallel to the degree of ischemia. 11,12 The increase in QTD caused by ischemia is thought to result partially from an impaired response of the ischemic myocardium to cathecolamines or to an abnormal flux of calcium ion. 20 As is known, the end of the T wave electrocardiographically indicates the beginning of mechanical diastole.…”

Section: Relationship Of Qtd Parameters and The Extent Of Coronary Armentioning

confidence: 99%

“…10 Recently, it has been reported that QTD obtained by exercise ECG increases the diagnostic reliability of ST-segment changes. 11,12 We planned this study to test whether, in addition to QTD and QTcD, the QT dispersion ratio (QTDR), which is shown to be more specific than QTcD for ventricular arrhythmias, 13 and differences between exercise and rest QTcD and QTDR, which are first evaluated, increase the diagnostic accuracy of ECG in women.…”

Section: Introductionmentioning

confidence: 99%

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New parameters in the interpretation of exercise testing in women: QTC dispersion and QT dispersion ratio difference

Özdemi̇r¹,

Altunkeser²,

Aydın³

et al. 2002

Clinical Cardiology

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SummaryBackground: It has been reported that the increase of QT dispersion (QTD) that occurs due to increased inhomogeneity of the ventricular repolarization because of transient ischemia obtained by standard 12-lead electrocardiogram (ECG), the changes during exercise, and the differences between exercise and rest increase the accuracy of exercise test in the diagnosis of coronary artery disease (CAD).Hypothesis: This study was designed to investigate the value of QTD parameters, which are reported to increase the diagnostic accuracy of exercise test in women.Methods: Ninety-seven women who had undergone coronary angiography and exercise test were evaluated for diagnosis of chest pain. QT dispersion was calculated using the measurements of the highest and lowest values of QT interval obtained by ECG during peak exercise. The QTc using Bazett's equation, and the QTD ratio (QTDR) using QT/RR were calculated, and QTcD and QTD ratios were obtained. The difference between QTcD and QTDR was determined by extracting the rest values from the exercise values.Results: The groups with normal coronaries (n = 48), single-vessel CAD (n = 24), and multivessel CAD (n = 25) were compared. The obtained QTD parameters at peak exercise and their differences between exercise and rest were found to be significantly increased in patients with CAD (p < 0.001).

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Corrected QT dispersion as a predictor of the frequency of paroxysmal tachyarrhythmias in patients with Wolff–Parkinson–White syndrome

Daoud

Abdelaziz

Elsamad

2014

Egyptian Journal of Chest Diseases and Tuberculosis

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Value of QT dispersion in the interpretation of treadmill exercise electrocardiograms of patients without exercise-induced chest pain or ST-segment depression

Cited by 17 publications

References 28 publications

Myocardial bridging is associated with exercise‐induced ventricular arrhythmia and increases in QT dispersion

Myocardial bridging is associated with exercise‐induced ventricular arrhythmia and increases in QT dispersion

New parameters in the interpretation of exercise testing in women: QTC dispersion and QT dispersion ratio difference

Corrected QT dispersion as a predictor of the frequency of paroxysmal tachyarrhythmias in patients with Wolff–Parkinson–White syndrome

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