Key result
In patients with stable coronary artery disease, frontal QRS-T angle, Tp-e duration, and Tp-e/QTc ratio were significantly higher in those with obstructive disease (SYNTAX > 0) compared to those without.
Why the study?
Although wide frontal QRS-T angle and markers of repolarization dispersion are linked to poor outcomes and arrhythmogenesis, their relationship with SYNTAX score in stable coronary artery disease needed investigation.
Do frontal QRS-T angle, Tp-e interval, and Tp-e/QTc ratio correlate with coronary artery severity assessed by SYNTAX score in stable coronary artery disease patients?
Cross-Sectional (n=403)
Yes
Do frontal QRS-T angle, Tp-e interval, and Tp-e/QTc ratio correlate with coronary artery severity assessed by SYNTAX score in stable coronary artery disease patients?
Absolute Event Rate: 89.87% vs 35.31%
p-value: p=<0.001
Frontal QRS-T angle and Tp-e duration on standard 12-lead ECG are independent predictors of coronary artery disease severity as assessed by SYNTAX score in patients with stable CAD.
Association between f(QRS-T) and repolarization indices is hypothesis-generating; prospective studies needed before clinical use.
Background: It is known that a wide frontal QRS-T(f[QRS-T]) angle in the electrocardiography (ECG) is associated with poor cardiovascular outcomes. The Tp-e (the interval from the peak to the end of the T wave) interval and Tp-e/QTc ratio show the dispersion of repolarization, and increased levels lead to ventricular arrhythmogenesis in congenital channelopathies and coronary heart disease. In this study, we aimed to investigate the relationship between f(QRS-T), Tp-e interval, and Tp-e/QTc ratio and SYNTAX score in stable coronary artery disease (SCAD) patients. Methods: A total of 403 patients who performed coronary angiography for SCAD were included. The study population was divided into two groups based on the SYNTAX score. Group 1 included 248 patients (high SYNTAX score > 0), and group 2 included 155 patients (low SYNTAX score = 0). SYNTAX score was calculated using an online SYNTAX score calculator from the coronary angiography images of each patient. The f(QRS-T) angle (QRS angle minus T angle) was calculated from the automated reports of the 12-lead ECG device. Tp-e interval and Tp-e/QTc ratio and other electrocardiographic parameters were recorded. Results: The mean SYNTAX score in group 1 was 8. F(QRS-T) angle, Tp-e duration, Tp-e/QT, and Tp-e/QTc were significantly higher in group 1 compared with group 2. In the multivariate regression analysis, F(QRS-T) angle and Tp-e duration were independent predictors for SYNTAX scores in SCAD patients. Conclusions: Our study showed that Tp-e interval, Tp-e/QTc ratio, and f(QRS-T) angle were increased in patients with higher SYNTAX scores in patients with SCAD patients.
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Karadeniz et al. (2022) conducted a cross-sectional in Stable coronary artery disease (n=403). High SYNTAX score (>0) vs. Low SYNTAX score (=0) was evaluated on Frontal QRS-T angle (degrees) (p=<0.001). In patients with stable coronary artery disease, frontal QRS-T angle, Tp-e duration, and Tp-e/QTc ratio were significantly higher in those with obstructive disease (SYNTAX > 0) compared to those without.
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