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Relationship between impaired repolarization parameters and poor cardiovascular clinical outcomes in patients with

Mehmet Emin Kalkan1, Ahmet Güner1, Macit Kalçik2

  • 1Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.

Coronary Artery Disease
|May 19, 2021
PubMed

Insights

Congenital coronary artery anomalies (CCAAs) linked to poor outcomes can be predicted by repolarization abnormalities. Specific ECG markers like Tp-e interval and frontal QRS/T angle help identify high-risk patients with these serious heart conditions.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Imaging

Background:

  • Congenital coronary artery anomalies (CCAAs) can lead to severe complications like sudden cardiac death (SCD).
  • Identifying patients at risk for adverse cardiovascular events is crucial for timely intervention.

Purpose of the Study:

  • To investigate the association between impaired repolarization parameters and poor clinical outcomes in patients with potentially serious CCAAs.
  • To determine if specific electrocardiographic (ECG) markers can predict adverse events in this population.

Main Methods:

  • Retrospective analysis of 85 patients with potentially serious CCAAs diagnosed via conventional and coronary computed tomography angiography (CCTA).
  • Evaluation of ECG parameters including Tp-e interval, Tp-e/QTc ratio, and frontal QRS/T angle (fQRSTa).
  • Cardiac events defined as sustained ventricular arrhythmias, syncope, cardiac arrest, or SCD, with a median follow-up of 24 months.

Main Results:

  • The interarterial course (IAC) anomaly was more frequent in patients with poor outcomes.
  • Prolonged Tp-e interval, increased Tp-e/QTc ratio, and wider fQRSTa were significantly greater in patients experiencing cardiac events.
  • IAC, high Tp-e/QTc ratio, and high fQRSTa independently predicted poor clinical outcomes and reduced cardiac event-free survival.

Conclusions:

  • Impaired repolarization parameters (wider fQRSTa, prolonged Tp-e interval, increased Tp-e/QTc ratio) are associated with adverse cardiovascular outcomes in patients with potentially serious CCAAs.
  • These ECG markers, along with IAC, can serve as independent predictors of poor prognosis in CCAA patients.
Abstract

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