QT dispersion: another way to diagnose coronary artery disease


DOI: https://dx.doi.org/10.18565/therapy.2021.4.64-70

Fedulaev Yu.N., Klykov L.L., Lebedeva A.Yu., Shoshina I.N., Makarova I.V., Pinchuk T.V.

1) N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow; 2) V.P. Demikhov City Clinical Hospital of the Department of Healthcare of Moscow; 3) I.V. Davydovsky City Clinical Hospital of the Department of Healthcare of Moscow
Abstract. Aim: to evaluate QTd and QTcd parameters in patients with long-standing complete intraventricular block and verified coronary atherosclerosis.
Material and methods. 112 patients with complete long-term intraventricular block were included in the observational study. 84 patients had a history of prior myocardial infarction and chronic heart failure with preserved ejection fraction, 28 had no coronary history. All participants had an ambulatory ECG monitoring and coronary angiography. Patients were divided into four groups: 1 – single-vessel coronary artery disease (CAD); 2 – two-vessel CAD; 3 – three-vessel CAD; 4 – normal coronary arteries (control group).
Results. The QTd and QTcd parameters measured at rest were significantly different in the groups (p <0,001 for both parameters) being higher in group 3 (three-vessel CAD) compared to the others. A comparative analysis of QTd and QTcd at maximum heart rate, as well as QTdD and QTcdD, revealed significant differences between the groups with the maximum values recorded in patients with one-vessel CAD. The median QTd at maximum heart rate was 67 ms in group 1 (vs 34 ms in control group and 50 ms in group 3; p <0,001 in both cases), the median QTcd was 77 ms (vs 39 ms in control group and 52 ms in group 3; p <0.001). The results of a correlation analysis demonstrated a significant inverse correlation between the QTd values at the maximum heart rate and the number of affected vessels (ρ = -0,706; p <0,001), as well as between the QTcd at the maximum heart rate and the number of affected vessels (ρ = -0,818 ; p <0,001). Dependence of the number of affected vessels on the QTcd at maximum heart rate was described by the following equation: Y = 4,81 - 0.043 × XQTcd, where Y was the number of affected vessels (from 1 to 3), XQTcd was the QTcd measured at maximum heart rate.
Conclusion. The use of QTd and QTcd parameters represents a new opportunity in ECG diagnostics of stable CAD in patients with complete intraventricular block.
Keywords: corrected QT dispersion, QT dispersion, electrocardiography, coronary angiography, coronary artery disease, atherosclerosis
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About the Autors

Yuri N. Fedulaev, MD, professor, head of the Department of faculty therapy of the Faculty of pediatrics, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 115280, Moscow, 1/1/15 Velozavodskaya Str. Tel.: +7 (905) 717-62-47. E-mail: kuwert@yandex.ru, ORCID: 0000-0003-4040-2971
Lev L. Klykov, PhD, doctor of the Department of endovascular diagnostics and treatment, V.P. Demikhov City Clinical Hospital of the Department of Healthcare of Moscow. Address: 109263, Moscow, 4 Shkuleva Str. Tel.: +7 (905) 717-62-47. E-mail: kuwert@yandex.ru. ORCID: 0000-0001-7622-0366
Anastasia Yu. Lebedeva, MD, professor of the Department of hospital therapy No. 1 of the Faculty of medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Deputy Chief medical officer of I.V. Davydovsky City Clinical Hospital of the Department of Healthcare of Moscow. Address: 111539, Moscow, 23 Veshnyakovskaya Str. Tel.: +7 (905) 717-62-47. E-mail: kuwert@yandex.ru. ORCID: 0000-0002-4060-0786
Irina N. Shoshina, cardiologist, Chief freelance cardiologist of the South-Eastern Administrative District, Outpatient Clinic of V.P. Demikhov City Clinical Hospital of the Department of Healthcare of Moscow. Address: 109263, Moscow, 4 Shkuleva Str. Tel.: +7 (905) 717-62-47. E-mail: kuwert@yandex.ru. ORCID: 0000-0002-2183-4405
Irina V. Makarova, assistant of the Department of faculty therapy of the Faculty of pediatrics, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 115280, Moscow, 1/1/15 Velozavodskaya Str. Tel.: +7 (905) 575-88-22. E-mail: irina-makarova93@mail.ru. ORCID: 0000-0001-5127-1300
Tatiana V. Pinchuk, PhD, associate professor of the Department of faculty therapy of the Faculty of pediatrics, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 115280, Moscow, 1/1/15 Velozavodskaya Str. Tel.: +7 (916) 174-78-74. E-mail: doktor2000@inbox.ru. ORCID: 0000-0002-7877-4407


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