Key result
Prolonged Tpe interval linked to ~2.5-fold higher odds of coronary slow flow.
Why the study?
Coronary slow flow can cause impaired myocardial perfusion leading to fatal ventricular arrhythmias and sudden cardiac death, but non-invasive predictors are needed.
Do prolonged Tpe interval and Tpe/QT ratio predict coronary slow flow in patients undergoing coronary angiography?
Case-Control (n=128)
Do prolonged Tpe interval and Tpe/QT ratio predict coronary slow flow in patients undergoing coronary angiography?
Prolonged Tpe interval and increased Tpe/QT ratio on resting ECG are reliable non-invasive predictors of coronary slow flow.
Background: Coronary slow flow (CSF) could result in impaired myocardium perfusion with subsequent adverse outcomes in terms of fatal ventricular tachy-arrhythmias and sudden cardiac death (SCD). We aimed to assess the value of electrocardiogram (ECG) as a non-invasive modality to predict CSF and its resulting outcomes.Methods: Out of 128 patients underwent coronary angiography; 64 patients had CSF and the other 64 patients had a normal flow defined as control group. The demographic, angiographic, and ECG characteristics were compared in both groups.Results: Tpe interval and Tpe/QT ratio were statistically significantly higher in CSF group in comparison to control group (85.25 ± 6.52 vs. 72.36 ± 5.86 ms, P < 0.001 and 0.21 ± 0.02 vs. 0.17 ± 0.01, P < 0.001, respectively). The receiver operating curve (ROC) statistical analysis revealed that Tpe interval > 74.5 ms (sensitivity 82%, specificity 56%), and Tpe/QT ratio > 0.19 (sensitivity 88%, specificity 54%) were reliable cut off values for predicting CSF. The multivariate analysis revealed that diabetes mellitus (OR=1.738, 95% CI:1.089-2.771, P=0.02), smoking (OR=1.724, 95% CI: 1.017-2.926, P=0.04), Tpe interval > 74.5 ms (OR=2.492, 95% CI: 1.328-4.587, P=0.004) and Tpe/QT ratio > 0.19 (OR=2.288, 95% CI: 1.306-4.068, P=0.004) could be defined as strong reliable predictors of CSF.Conclusions: ECG parameters in terms of prolonged Tpe interval and Tpe/QT ratio could be more frequently noted in CSF subjects, compared to others having normal flow. Specifically, Tpe interval > 74.5 ms in addition to Tpe/QT ratio > 0.19 could be considered powerful predictors of CSF
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Refaat et al. (2026) conducted a case-control in Coronary Slow Flow (n=128). Prolonged Tpe interval (> 74.5 ms) vs. Normal Tpe interval (≤ 74.5 ms) was evaluated on Coronary slow flow (CSF) (OR 2.492, 95% CI 1.328-4.587, p=0.004). A prolonged Tpe interval > 74.5 ms (OR 2.492; 95% CI 1.328-4.587; P=0.004) and Tpe/QT ratio > 0.19 were strong independent predictors of coronary slow flow during angiography.
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