Key result
The QT dispersion ratio (QTdR) was the best electrocardiographic parameter to detect coronary arterial narrowing greater than 50%, with an area under the curve of 0.858.
Why the study?
Do ECG parameters such as P and QT dispersions predict the presence and severity of stable coronary artery disease in patients with preserved left ventricular function?
Cross-Sectional (n=250)
No
Do ECG parameters such as P and QT dispersions predict the presence and severity of stable coronary artery disease in patients with preserved left ventricular function?
QT dispersion ratio and P wave dispersion on a standard resting ECG correlate significantly with angiographic severity of coronary artery disease and may serve as non-invasive screening tools.
QTdR may aid noninvasive detection of significant CAD; hypothesis-generating for ECG screening in stable disease with preserved LVEF.
BACKGROUND AND OBJECTIVES: The 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 METHODS: Two 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. RESULTS: Group 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). CONCLUSION: Presence and severity of CAD can be determined by using ECG in patients with stable CAD and normal left ventricular function.
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Şahin et al. (2016) conducted a cross-sectional in Stable Coronary Artery Disease (n=250). Electrocardiographic parameters (QT dispersion ratio) vs. Coronary angiography (reference standard) was evaluated on Diagnostic accuracy of QT dispersion ratio (QTdR) to detect coronary arterial narrowing ≥50% (AUC 0.858, p=<0.001). The QT dispersion ratio (QTdR) was the best electrocardiographic parameter to detect coronary arterial narrowing greater than 50%, with an area under the curve of 0.858.
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