| Autor: |
Stephen Mcswiggan, Simon Ogston, Dominic Steeples, Kenneth Y.K. Wong, Allan D. Struthers, N Kennedy, Periaswamy Velavan, Jeff B Ball, Suzanne Y.S. Wong, Ronald S. MacWalter |
| Rok vydání: |
2015 |
| Předmět: |
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| Zdroj: |
Journal of Cardiology & Current Research. 2 |
| ISSN: |
2373-4396 |
| DOI: |
10.15406/jccr.2015.02.00046 |
| Popis: |
Background: QT peak prolongation identiied patients at risk of death or non-fatal MI. We tested the hypothesis that QT peak prolongation might be associated with signiicant myocardial ischaemia in two separate cohorts to see how widely applicable the concept was. Methods and Results: In theirst study, 134 stroke survivors were prospectively recruited and had 12-lead ECGs and Nuclear myocardial perfusion scanning. QT peak was measured in lead I of a 12-lead ECG and heart rate corrected by Bazett's formula (QTpc). QTpc prolongation to 360ms or more was 92% speciic at diagnosing severe myocardial ischaemia. This hypothesis-generating study led us to perform a second prospective study in a different cohort of patients who were referred for dobutamine stress echocardiography. 13 of 102 patients had signiicant myocardial ischaemia. Signiicant myocardial ischaemia was associated with QT peak prolongation at rest (mean 354ms, 95% CI 341-367ms, compared with mean 332ms, 95% CI 327-337ms in those without signiicant ischaemia; p=0.002). QT peak prolongation to 360ms or more was 88% speciic at diagnosing signiicant myocardial ischaemia in the stress echocardiography study. QT peak prolongation to 360ms or more was associated with over 4-fold increase odds ratio of signiicant myocardial ischaemia. The Mantel- Haenszel Common Odds Ratio Estimate=4.4, 95% CI=1.2-16.0, p=0.023. Conclusion: QT peak (QTpc) prolongation to 360ms or more should make us suspect the presence of signiicant myocardial ischaemia. Such patients merit further investigations for potentially treatable ischaemic heart disease to reduce their risk of subsequent death or non-fatal MI. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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