New markers for ventricular repolarization in coronary slow flow: Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio
Kayihan Karaman1, Fatih Altunkaş1, Mustafa Çetin2
1Department of Cardiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey.
Insights
Patients with coronary slow flow (CSF) exhibit significantly increased Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio, indicating altered ventricular repolarization. These electrocardiographic markers may help identify individuals at risk for arrhythmias associated with CSF.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Diagnostics
Background:
- Coronary slow flow (CSF) is a condition with delayed distal vasculature opacification in normal coronary arteries, potentially leading to serious cardiac events like myocardial infarction and sudden cardiac death.
- Ventricular arrhythmogenesis can be predicted by electrocardiographic parameters such as the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio.
Purpose of the Study:
- To evaluate ventricular repolarization in patients diagnosed with coronary slow flow (CSF).
- To assess the utility of Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio as indicators of ventricular repolarization abnormalities in CSF patients.
Main Methods:
- The study included 50 patients with CSF and 51 healthy controls.
- Coronary flow was assessed using the Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC).
- Electrocardiographic parameters, including Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio, were measured and compared between the CSF group and the control group.
Main Results:
- Patients with CSF showed significantly higher values for QT, QTc, QTd, and QTcd compared to controls (P < 0.001 for QT, QTd, QTcd; P = 0.019 for QTc).
- The Tp-e interval was significantly increased in CSF patients (117 ± 21 ms) versus controls (96 ± 16 ms, P < 0.001).
- Significantly higher Tp-e/QT (0.30 ± 0.06 vs 0.27 ± 0.06, P = 0.005) and Tp-e/QTc (0.27 ± 0.06 vs 0.24 ± 0.05, P < 0.001) ratios were observed in CSF patients. Multivariate analysis confirmed an association between increased Tp-e and Tp-e/QT ratio with CSF.
Conclusions:
- The study demonstrates significantly elevated Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio in patients with coronary slow flow compared to control subjects.
- These findings suggest that Tp-e interval and its ratios are valuable electrocardiographic markers for assessing ventricular repolarization abnormalities in patients with CSF.
Background:
Coronary slow flow (CSF) is characterized by normal or near-normal coronary arteries with delayed opacification of the distal vasculature that it may cause angina pectoris, acute myocardial infarction, life-threatening arrhythmias, and sudden cardiac death. The Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio are also known as predictors of ventricular arrhythmogenesis. The aim of this study was to assess ventricular repolarization in patients with CSF by using Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio.
Methods:
This study included 50 patients with CSF and 51 control subjects. Coronary flow rates of all subjects were documented by thrombolysis in myocardial infarction (TIMI) frame count (TFC). Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were measured from the 12-lead electrocardiogram. These parameters were compared between groups.
Results:
In electrocardiographic parameters analysis, QT, QTc, QTd, and QTcd were significantly increased in CSF patients compared with the control subjects (P < 0.001, P = 0.019, P < 0.001, P < 0.001, respectively). The Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio in the CSF patients were significantly higher than those in the control subjects (Tp-e: 117 ± 21 milliseconds [ms] vs 96 ± 16 ms, P < 0.001; Tp-e/QT: 0.30 ± 0.06 vs 0.27 ± 0.06, P = 0.005; Tp-e/QTc: 0.27 ± 0.06 vs 0.24 ± 0.05, P < 0.001). In the multivariate analysis, increased Tp-e and Tp-e/QT ratio were associated with CSF.
Conclusions:
Our study revealed that when compared to the control subjects, Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc were significantly increased in the CSF patients.
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