R-Wave Peak Time and Impaired Coronary Collateral Circulation in Chronic Total Occlusion

Area of Science:

• Cardiology
• Medical Imaging
• Electrocardiography

Background:

• Chronic total occlusion (CTO) presents complex coronary artery disease.
• Myocardial perfusion in CTO patients relies heavily on coronary collateral circulation (CCC).
• Simple, non-invasive markers for assessing CCC adequacy are clinically valuable.

Purpose of the Study:

• To investigate the association between R-wave peak time (RWPT) and poor CCC in patients with CTO.
• To determine if RWPT, an electrocardiography (ECG) marker, can identify impaired collateralization.

Main Methods:

• A cross-sectional observational study of 92 consecutive CTO patients.
• Patients were classified into good (n=52) and poor (n=40) CCC groups based on angiographic assessment.
• Demographic, laboratory, angiographic, and ECG data were analyzed, including RWPT and QRS duration.

Main Results:

• Patients with poor CCC were older and had significantly longer QRS duration and prolonged RWPT.
• Lower triglyceride levels were observed in the poor CCC group.
• Multivariate analysis identified age (OR: 1.058) and RWPT (OR: 1.069) as significant predictors of poor CCC.

Conclusions:

• RWPT is significantly associated with poor CCC in CTO patients.
• RWPT offers adjunctive, non-invasive information on collateral adequacy.
• RWPT is an easily obtainable ECG parameter that can provide incremental diagnostic value.