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Coronary microvascular dysfunction is associated with baseline QTc prolongation amongst patients with chest pain and

Jaskanwal D Sara1, Ryan J Lennon2, Michael J Ackerman1

  • 1Division of Cardiovascular Diseases, Mayo College of Medicine, Rochester, MN, USA.

Journal of Electrocardiology
|December 2, 2015
PubMed

Insights

Coronary microvascular dysfunction (CMD) is linked to longer heart rate corrected QT intervals (QTc). This study found a significant association between abnormal coronary flow reserve and prolonged QTc in patients with chest pain and non-obstructive coronary artery disease.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Vascular Biology

Background:

  • Coronary microvascular dysfunction (CMD) is a significant cause of myocardial ischemia and adverse cardiovascular outcomes.
  • While acute transmural ischemia is known to prolong the QT interval, the impact of CMD on cardiac repolarization remains unclear.
  • This study investigates the relationship between CMD and resting heart rate corrected QT interval (QTc) prolongation.

Purpose of the Study:

  • To determine if coronary microvascular dysfunction (CMD) is associated with an increased resting heart rate corrected QT interval (QTc).

Main Methods:

  • Patients with chest pain and non-obstructive coronary artery disease (CAD) underwent coronary flow reserve (CFR) measurement via intracoronary adenosine.
  • The heart rate corrected QT interval (QTc) was calculated from 12-lead ECGs prior to the procedure.
  • QTc intervals were compared between patients with normal and abnormal CFR (ratio ≤2.5).

Main Results:

  • 30% of 926 patients exhibited CMD.
  • Patients with abnormal CFR had significantly longer QTc intervals (median 420 ms vs. 416 ms, p<0.001).
  • CMD was associated with a trend towards increased QTc (3.09 ms, p=0.055) in a multivariable regression model.

Conclusions:

  • Coronary microvascular dysfunction (CMD) may be associated with increased baseline QTc interval.
  • Further research in larger cohorts is needed to elucidate the clinical significance of this association.
Abstract

Keywords:
Cardiovascular eventsCoronary microvascular dysfunctionNon-obstructive coronary artery diseaseQT interval prolongationVentricular arrhythmia

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