Can QT dispersion improve the accuracy of stress ECG TMT in detecting myocardial ischemia in chronic stable CAD patients? A stress myocardial perfusion imaging study

Abstract Background QT dispersion (QTd) is related to regional variations in myocardial repolarization. Our study aims to assess the value of QTd in prediction of myocardial ischemia and its severity during stress imaging. We enrolled one hundred patients having stable coronary artery disease (CAD) and fulfilling the “Appropriateness criteria for cardiac radionuclide imaging” (MPI). They were divided into group I including patients with MPI-detected ischemia (50 patients) and group II including patients with normal perfusion scan (50 patients). We excluded unstable CAD and all other causes affecting QTd. During isotope scan, ECGs were taken and QTd was calculated at rest and at maximum heart rate. Results QTd was significantly higher in the ischemic group both at rest and exercise (P = 0.000). QTd difference, the difference between QTd at rest and stress, was calculated. QTd difference was significantly lower in normal than in ischemic group (P = 0.003). There was a significant positive correlation between QTd difference and defect size (P = 0.04). Conclusion QTd increases in ischemia and the QTd difference (between rest and stress) correlates positively with severity of ischemia. QTd and QTd difference could be used to improve the accuracy of stress imaging test.

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A serial optical frequency-domain imaging study of early and late vascular responses to bioresorbable-polymer sirolimus-eluting stents for the treatment of acute myocardial infarction and stable coronary artery disease patients: results of the MECHANISM-ULTIMASTER study

Cardiovascular Intervention and Therapeutics ◽

10.1007/s12928-021-00777-4 ◽

2021 ◽

Author(s):

Tomonori Itoh ◽

◽

Hiromasa Otake ◽

Takumi Kimura ◽

Yoshiro Tsukiyama ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Frequency Domain ◽

Stable Coronary Artery Disease ◽

Imaging Study ◽

Optical Frequency ◽

Bioresorbable Polymer ◽

Artery Disease

AbstractThe purpose of this study was to assess early and late vascular healing in response to bioresorbable-polymer sirolimus-eluting stents (BP-SESs) for the treatment of patients with ST-elevation myocardial infarction (STEMI) and stable coronary artery disease (CAD). A total of 106 patients with STEMI and 101 patients with stable-CAD were enrolled. Optical frequency-domain images were acquired at baseline, at 1- or 3-month follow-up, and at 12-month follow-up. In the STEMI and CAD cohorts, the percentage of uncovered struts (%US) was significantly and remarkably decreased during early two points and at 12-month (the STEMI cohort: 1-month: 18.75 ± 0.78%, 3-month: 10.19 ± 0.77%, 12-month: 1.80 ± 0.72%; p < 0.001, the CAD cohort: 1-month: 9.44 ± 0.78%, 3-month: 7.78 ± 0.78%, 12-month: 1.07 ± 0.73%; p < 0.001 respectively). The average peri-strut low-intensity area (PLIA) score in the STEMI cohort was significantly decreased during follow-up period (1.90 ± 1.14, 1.18 ± 1.25, and 1.01 ± 0.72; p ≤ 0.001), whereas the one in the CAD cohort was not significantly changed (0.89 ± 1.24, 0.67 ± 1.07, and 0.64 ± 0.72; p = 0.59). In comparison with both groups, differences of %US and PLIA score at early two points were almost disappeared or close at 12 months. The strut-coverage and healing processes in the early phase after BP-SES implantation were significantly improved in both cohorts, especially markedly in STEMI patients. At 1 year, qualitatively and quantitatively consistent neointimal coverage was achieved in both pathogenetic groups.

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Prolonged QTc Dispersion Correlates with Coronary Artery Disease in Acute ST Elevated Myocardial Infarction (STEMI)

Cardiovascular Journal ◽

10.3329/cardio.v5i2.14322 ◽

2013 ◽

Vol 5 (2) ◽

pp. 173-181 ◽

Cited By ~ 1

Author(s):

NI Sharafat ◽

M Khalequzzaman ◽

M Akhtaruzzaman ◽

AK Choudhury ◽

S Hasem ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Qt Dispersion ◽

Qtc Dispersion ◽

Group I ◽

The Mean ◽

Group Ii ◽

Artery Disease ◽

Vessel Score ◽

Vessel Involvement

Background: It has been found that there is strong association of QT dispersion and QT dispersion ratio with extent and severity of coronary artery disease. Qualitative importance of QTc dispersion on the base line ECG in patients with MI is recognized clinically but quantification of this phenomenon is less commonly used in clinical practice, which might be a better independent risk predictor of this group of patients. Methods: A total of 100 patients were selected, Study populations sub-divided into two groups on the basis of QTc dispersion. In group I (comparison group): QTc dispersion is <60 milliseconds (msec) in group II (study group) : QTc dispersion e60milliseconds(msec). 50 patients in each group. QT dispersion was calculated on standard resting 12 lead ECGs. QT interval was measured from the beginning of the inscription of the QRS complex to the point at which the T wave returned to the isoelectric line. Angiographic severity of coronary artery disease was assessed by- Vessel score, Friesinger score and Leaman score. Interpretation of coronary angiogram was reviewed by at least two cardiologists. . Results: The mean vessel score for group I patients was 1.16±0.68 and that of group II patients was 2.30±0.64 and the mean difference was statistically significant (p<0.05). Patients those had single vessel involvement had mean QTc dispersion 57.05, patients those had double vessel disease mean QTc dispersion was 102.00 and patients those had triple vessel involvement had mean QTc dispersion 177.60. There was a strong positive correlation with the QTc dispersion and increasing number of vessel involvement (Pearsons correlation coefficient). The mean Friesinger score for group I patients was 4.84±2.56 and that of group II patients was 9.80±2.60. The mean difference was significantly (p<0.05) higher in group II patients. There was a strong positive correlation between the QTc dispersion and Leaman score (Pearsons correlation coefficient). In group I patients 56% had insignificant coronary artery disease and 44% had significant coronary artery disease defined by Friesinger index (n=100). In group II patients 6% had Insignificant coronary artery disease & had 94% significant coronary artery disease. Conclusion: QTc dispersion>60 ms had independent predictive value for the severity of coronary artery disease. The greater the QTc dispersion the higher the number of coronary artery involvement. We observed that there is a positive correlation between prolonged QT dispersion and coronary artery disease severity in terms of Vessel score, Friesinger score, Leaman score. DOI: http://dx.doi.org/10.3329/cardio.v5i2.14322 Cardiovasc. j. 2013; 5(2): 173-181

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Quality of Life of Patients with Stable Coronary Artery Disease Combined with Non-Alcoholic Fatty Liver Disease

Galician Medical Journal ◽

10.21802/gmj.2016.4.16 ◽

2016 ◽

Vol 23 (4) ◽

pp. 2016416

Author(s):

Iryna Vakalyuk ◽

Nataliya Virstyuk ◽

Vitaliy Petryna

Keyword(s):

Quality Of Life ◽

Liver Disease ◽

Stable Coronary Artery Disease ◽

Control Group ◽

Alcoholic Fatty Liver ◽

Group I ◽

Sf 36 ◽

Artery Disease ◽

Alcoholic Fatty Liver Disease

Quality of life assessment is an integral part of a comprehensive treatment in modern medical practice. Analysis of quality of life of patients with comorbidities is an interesting and poorly understood issue. The objective of the research was to evaluate the quality of life of patients with postinfarction cardiosclerosis depending on the presence and progression of non-alcoholic fatty liver disease (NAFLD).Material and methods. The research included 300 patients with stable coronary artery disease (CAD). They included 160 patients without NAFLD (Group I) and 140 patients with NAFLD (Group II). 89 patients of Group II suffered from non-alcoholic liver disease (NALD) and 51 patients from non-alcoholic steatohepatitis (NASH). The control group consisted of 20 apparently healthy individuals. SF-36 and MacNew questionnaires were used to assess the quality of life. Results. The overall estimate according to SF-36 questionnaire detected a significant decrease in the patient’s quality of life due to their low physical activity, mental ill-being, limitation of daily activities, significant effect of pain and low assessment of their health. Decrease in the quality of life was clearly dependent on NAFLD stage and was the lowest in case of NASH. The overall estimate of quality of life according to MacNew questionnaire was 1.5 times lower in patients of Group I compared to the control group, decreased almost by 1.4 times in patients with NALD compared to Group I and was 1.5 times lower in case of NASH compared to the patients with NALD (p<0.05). Conclusions. Patients with stable CAD combined with NAFLD were characterized by decrease in quality of life due to its physical, psycho-emotional and social components. Quality of life of patients with postinfarction cardiosclerosis depended on NAFLD progression and was the lowest in case of NASH.

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Obesity as a risk factor of contrast-induced acute kidney injury in patients with arterial hypertension and stable coronary artery disease

Systemic Hypertension ◽

10.26442/2075082x.2020.4.200546 ◽

2021 ◽

Vol 17 (4) ◽

pp. 63-67

Author(s):

Olga Iu. Mironova ◽

Olga A. Sivakova ◽

Viktor V. Fomin

Keyword(s):

Risk Factors ◽

Serum Creatinine ◽

Contrast Media ◽

Stable Coronary Artery Disease ◽

Kidney Injury ◽

Before And After ◽

The Difference ◽

Artery Disease ◽

Stable Cad ◽

Contrast Media Administration

Background. The prevalence of obesity in patients with stable coronary artery disease (CAD) and arterial hypertension (AH) is increasing each year. As the number of percutaneous coronary interventions requiring contrast media administration is rising in this group of patients, the risk of contrast-induced acute kidney injury (CI-AKI) remains high. The most important risk factors of CI-AKI in this group of patients remain to be determined as well as their prognostic significance. Aim. The aim of the study was to assess the role of obesity as a risk factor of CI-AKI in patients with stable CAD and AH. Materials and methods. 863 patients with stable CAD and AH were included in the prospective open observational cohort study (ClinicalTrials.gov ID NCT04014153). 398 patients were obese and 465 had body mass index (BMI) below 30 kg/m2. CI-AKI was defined as the 25% rise (or 0.5 mg/dl) of serum creatinine from baseline assessed 48 hours after administration of contrast media. The primary endpoint was the development of CI-AKI. Results. The rate of CI-AKI in patients with obesity was 12.6%, without obesity 12.7%, but the difference between groups was not statistically significant (p=0.935, 95% CI -0.0430.046). The rate of CI-AKI in male patients with obesity was higher than in female ones. The logistic regression model of CI-AKI development in patients with stable CAD, AH and obesity was build (AUC 0.9928, р0,0001, 95% CI 0.98191) and included age, weight, body mass index, female gender, heart failure, diabetes mellitus, proteinuria, anemia, baseline creatinine, contrast volume and the difference between baseline serum creatinine and creatinine level after the contrast media exposure. The baseline level of creatinine and the difference between the levels of creatinine before and after contrast media administration were statistically significant risk factors in the model. Conclusion. The rate of CI-AKI in patients with stable CAD, AH and obesity was 12.6%. The main risk factors of CI-AKI development in multiple logistic regression model were the baseline level of creatinine and the difference between levels of serum creatinine before and after contrast media administration.

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