Key result
QT interval parameters, including mean QTc, were significantly longer in patients with syncope compared to controls (P<0.0005), and prolonged QTc was associated with higher syncope severity.
Why the study?
Do QT interval parameters improve the diagnostic accuracy and severity assessment of syncope compared to controls?
Case-Control (n=289)
No
Do QT interval parameters improve the diagnostic accuracy and severity assessment of syncope compared to controls?
p-value: p=<0.0005
Prolonged QTc and QT dispersion are significantly associated with syncope and higher clinical risk scores, suggesting utility in risk stratification.
QTc prolongation was associated with syncope severity; leaves open diagnostic utility pending prospective validation.
BACKGROUND: This study aimed to evaluate the use of QT intervals, their diagnostic predictive value in patients with syncope and their relationship with syncope severity. METHODS: One hundred and forty nine patients with a diagnosis of syncope were admitted to Internal Medicine departments at the University of Palermo, Italy, between 2006 and 2012, and 140 control subjects hospitalised for other causes were enrolled. QT maximum, QT minimum, QTpeak, QT corrected, QT dispersion and Tpeak-to-Tend interval were compared between two groups. The paper medical records were used for scoring with San Francisco Syncope Rule (SFSR), Evaluation of Guidelines in SYncope Study (EGSYS) score and Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) risk score. RESULTS: Mean QTc (p < 0.0005), mean QTmax (p < 0.0005), mean QTdisp (p < 0.0005), mean QTpeak (p = 0.005) and mean TpTe (p = 0.018) were significantly longer in patients with syncope compared with control subjects. A QTc > 424.8 ms (sensibility: 81.88 - specificity: 57.86) showed the greatest predictive value for diagnosis of syncope. On the EGSYS score and on the OESIL score, QTc was significantly prolonged in high-risk patients compared with low-risk patients. On the San Francisco Syncope Rule, QTc and QTdisp were significantly prolonged in high-risk patients compared with low-risk patients. CONCLUSION: Mean QTc, mean QTdisp, mean TpTe, mean QTmax and mean QTpeak were significantly longer in patients with syncope compared with control subjects. Furthermore, prolonged QTc and QTdisp were associated with major severe syncope according to San Francisco Syncope Rule, EGSYS and OESIL risk scores.
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Buttà et al. (2014) conducted a case-control in Syncope (n=289). QT interval parameters vs. Control subjects hospitalized for other causes was evaluated on Mean QTc (p=<0.0005). QT interval parameters, including mean QTc, were significantly longer in patients with syncope compared to controls (P<0.0005), and prolonged QTc was associated with higher syncope severity.
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