Evaluation of Tpe interval and Tpe/QT ratio in patients with slow coronary flow

zehir, regayip; Karabay, Can Yucel; KALAYCI, Arzu; AKGÜN, Taylan; KIRMA, Cevat; kılıçgedik, alev

Evaluation of Tpe interval and Tpe/QT ratio in patients with slow coronary flow

Regayip ZEHİR, (Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital; İstanbul-Turkey)

Can Yücel KARABAY, (Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital; İstanbul-Turkey)

Arzu KALAYCI, (Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital; İstanbul-Turkey)

Taylan AKGÜN, (Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital; İstanbul-Turkey)

Alev KILIÇGEDİK, (Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital; İstanbul-Turkey)

Cevat KIRMA (Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital; İstanbul-Turkey)

The Anatolian Journal of Cardiology

11 3

Yıl: 2015 Cilt: 15 Sayı: 6 Sayfa Aralığı: 463 - 467 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Evaluation of Tpe interval and Tpe/QT ratio in patients with slow coronary flow

Öz:

Amaç: Koroner yavaş akım (KYA) normal bir koroner arterde distal damar yatağının gecikmiş opak tutması olarak tanımlanır. Birçok çalışmada elektrokardiyografide T dalgasının zirvesi ve sonu arasındaki mesafenin (Tpe) ve Tpe/QT oranın malign ventriküler aritmiler ile ilişkisini göstermiştir. Bu çalışmada KYA tespit edilen hastalarda Tpe ve Tpe/QT oranlarını kullanarak ventriküler repolarizasyonu değerlendirmeyi amaçladık. Yöntem: Çalışma popülasyonu anjiyografik olarak kanıtlanmış KYA olan 33 hasta ve koroner anjiyografileri normal olan ve KYA saptanmayan 33 kontrol hastasından oluşmaktadır. Hastaların ve kontrol grubunun koroner akım hızları TIMI (Thrombolysis in Myocardial Infarction) kare sayıları ile dokümante edildi. Hastalardan alınan elektrokardiyografiden Tpe ve Tpe/QT oranları kaydedildi ve gruplar arasında karşılaştırıldı. Bulgular: Her iki grup arasında bazal özellikler açısından fark saptanmamıştır. KYA grubunda kontrol grubuna göre Tpe, Tpe/QT ve Tpe/QTc oranları istatistiki anlamlı şekilde artmıştır (p<0,001). Sonuç: KYA hastalarında Tpe ve Tpe/QT oranları artmıştır.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Koroner yavaş akım hastalarında Tpe mesafesi Tpe/QT oranının değerlendirilmesi

Öz:

Objective: Slow coronary flow (SCF) phenomenon is described as the delayed opacification of the distal vasculature and angiographically normal coronary arteries. Considerable studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (Tpe) may correspond to the transmural dispersion of repolarization and that increased Tpe interval and Tpe/QT ratio are associated with malignant ventricular arrhythmias. In this study, we intended to evaluate ventricular repolarization in patients with SCF by using the Tpe interval and Tpe/QT ratio.Methods: The study population included 33 patients with angiographically proven SCF and 33 control patients with angiographically proven normal coronary arteries without associated SCF. Coronary flow rates of patients and the control group were documented by TIMI (Thrombolysis in Myocardial Infarction) frame count. From the electrocardiograms, Tpe interval and Tpe/QT ratio were calculated and compared between groups.Results: No statistically significant difference was found between the two groups in terms of basic characteristics. Mean Tpe interval, Tpe/QT ratio, and Tpe/QTc ratio were prolonged in the study group compared to the control group (p<0.001).Conclusion: Tpe interval and Tpe/QT ratio were increased in SCF patients

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Singh S, Kothari SS, Bahl VK. Coronary slow flow phenomenon: an angiographic curiosity. Indian Heart J 2004; 56: 613-7.
2. Saya S, Hennebry TA, Lozano P, Lazzara R, Schechter E. Coronary slow flow phenomenon and risk for sudden cardiac death due to ventricular arrhythmias: a case report and review of literature. Clin Cardiol 2008; 31: 352-5. [CrossRef]
3. Kors JA, Ritsema van Eck HJ, van Herpen G. The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol 2008; 41: 575-80. [CrossRef]
4. Antzelevitch C, Sicouri S, Di Diego JM, Burashnikov A, Viskin S, Shimizu W, et al. Does Tpeak-Tend provide an index of transmural dispersion of repolarization? Heart Rhythm 2007; 4: 1114-6. [CrossRef]
5. Watanabe N, Kobayashi Y, Tanno K, Miyoshi F, Asano T, Kawamura M, et al. Transmural dispersion of repolarization and ventricular tachyarrhythmias. J Electrocardiol 2004; 37: 191-200. [CrossRef]
6. Gupta P, Patel C, Patel H, Narayanaswamy S, Malhotra B, Green JT, et al. T(p-e)/QT ratio as an index of arrhythmogenesis. J Electrocardiol 2008; 41: 567-74. [CrossRef]
7. Gibson CM, Cannon CP, Delay WL, Dodge JT Jr, Alexander B Jr, Marble SJ, et al. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation 1996; 93: 879-83. [CrossRef]
8. Castro Hevia J, Antzelevitch C, Torne´s Barzaga F, Dorantes Sanchez M, Dorticos Balea F, Zayas Molina R, et al. Tpeak-Tend and Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome. J Am Coll Cardiol 2006; 47: 1828-34. [CrossRef]
9. Goldenberg I, Moss AJ, Zareba W. QT interval: how to measure it and what is "normal." J Cardiovasc Electrophysiol 2006; 17: 333-6. [CrossRef]
10. Antzelevitch C, Shimizu W, Yan GX. Electrical heterogeneity and the development of arrhythmias. In: Olsson SB, Yuan S, Amlie JP, editors. Dispersion of ventricular repolarization: state of the art. Armonk (NY): Futura Publishing Company, Inc.; 2000.p.3.
11. Sicouri S, Antzelevitch C. A subpopulation of cells with unique electrophysiological properties in the deep subepicardium of the canine ventricle: The M cell. Circ Res 1991; 68: 1729. [CrossRef]
12. Yan GX, Wu Y, Liu T, Wang J, Marinchak RA, Kowey PR. Phase 2 early after depolarization as a trigger of polymorphic ventricular tachycardia in acquired long-QT syndrome: direct evidence from intracellular recordings in the intact left ventricular wall. Circulation 2001; 103: 2851. [CrossRef]
13. Yan GX, Rials SJ, Wu Y, Liu T, Xu X, Marinchak RA, et al. Ventricular hypertrophy amplifies transmural repolarization dispersion and induces early after depolarization. Am J Physiol 2001; 281: H1968.
14. Yan GX, Martin J. Electrocardiographic T wave: a symbol of transmural dispersion of repolarization in the ventricles. J Cardiovasc Electrophysiol 2003; 14: 639. [CrossRef]
15. Erikssen G, Liestøl K, Gullestad L, Haugaa KH, Bendz B, Amlie JP. The terminal part of the QT interval (T peak to T end): a predictor of mortality after acute myocardial infarction. Ann Noninvasive Electrocardiol 2012; 17: 85-94. [CrossRef]
16. Zhao X, Xie Z, Chu Y, Yang L, Xu W, Yang X, et al. Association between Tp-e/QT ratio and prognosis in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Clin Cardiol 2012; 35: 559-64. [CrossRef]
17. Mangieri E, Macchiarelli G, Ciavolella M, Barillà F, Avella A, Martinotti A, et al. Slow coronary flow: Clinical and histopathological features in patients with otherwise normal epicardial coronary arteries. Cathet Cardiovasc Diagn 1996; 37: 375-81. [CrossRef]
18. Kurtoğlu N, Akçay A, Dindar I. Usefulness of oral dipyridamole therapy for angiographic slow coronary artery flow. Am J Cardiol 2001; 87: 777-9. [CrossRef]
19. Cesar LA, Ramires JA, Serrano Junior CV, Meneghetti JC, Antonelli RH, da-Luz PL, et al. Slow coronary run off in patients with angina pectoris: Clinical significance and thallium 201 scintigraphic study. Braz J Med Biol Res 1996; 29: 605-13.
20. Kapoor A, Goel PK, Gupta SK. Slow coronary flow-a cause for angina with ST segment elevation and normal coronary arteries. Int J Cardiol 1998; 67: 257-61. [CrossRef]
21. Biçeroğlu S, Yıldız A, Bayata S, Yeşil M, Postacı N. Is there an association between left bundle branch block and coronary slow flow in patients with normal coronary arteries? Angiology 2007; 58: 685-8. [CrossRef]
22. Eslami V, Safi M, Taherkhani M, Adibi A, Movahed MR. Evaluation of QT, QT dispersion, and T-wave peak to end time changes after primary percutaneous coronary intervention in patients presenting with acute ST-elevation myocardial infarction. J Invasive Cardiol 2013; 25: 232-4.
23. Cappato R, Alboni P, Pedroni P, Gilli G, Antonioli GE. Sympathetic and vagal influences on rate-dependent changes of QT interval in healthy subjects. Am J Cardiol 1991; 68: 1188-93. [CrossRef]
24. Ishida S, Nakagava M, Fujino T, Yonemochi H, Saikawa T, Ito M. Circadian variation of QT interval dispersion: Correlation with heart rate variability. J Electrocardiol 1997; 30: 205-10. [CrossRef]
25. Koşuş A, Sağkan O, Dursun I, Elçik M, Yazıcı M, Şahin M, et al. Heart rate variability and QT dispersion in patients with slow coronary flow. Turk Kardiyol Dern Ars 2004; 32:10.
26. Yazıcı M, Demircan S, Durna K, Şahin M. The role of adrenergic activity in slow coronary flow and its relationship to TIMI frame count. Angiology 2007; 58: 393-400. [CrossRef]
27. Acar G, Yorgun H, İnci MF, Akkoyun M, Bakan B, Nacar AB, et al. Evaluation of Tp-e interval and Tp-e/QT ratio in patients with ankylosing spondylitis. Mod Rheumatol 2013 April 12. [CrossRef]
28. Mountantonakis S, Deo R. Biomarkers in atrial fibrillation, ventricular arrhythmias, and sudden cardiac death. Cardiovasc Ther 2012; 30: e74-80. [CrossRef]
29. Li JJ, Qin XW, Li ZC, Zeng HS, Gao Z, Xu B, et al. Increased plasma C-reactive protein and interleukin-6 concentrations in patients with slow coronary flow. Clin Chim Acta 2007; 385: 43-7. [CrossRef]

APA	zehir r, Karabay C, KALAYCI A, AKGÜN T, kılıçgedik a, KIRMA C (2015). Evaluation of Tpe interval and Tpe/QT ratio in patients with slow coronary flow. , 463 - 467.
Chicago	zehir regayip,Karabay Can Yucel,KALAYCI Arzu,AKGÜN Taylan,kılıçgedik alev,KIRMA Cevat Evaluation of Tpe interval and Tpe/QT ratio in patients with slow coronary flow. (2015): 463 - 467.
MLA	zehir regayip,Karabay Can Yucel,KALAYCI Arzu,AKGÜN Taylan,kılıçgedik alev,KIRMA Cevat Evaluation of Tpe interval and Tpe/QT ratio in patients with slow coronary flow. , 2015, ss.463 - 467.
AMA	zehir r,Karabay C,KALAYCI A,AKGÜN T,kılıçgedik a,KIRMA C Evaluation of Tpe interval and Tpe/QT ratio in patients with slow coronary flow. . 2015; 463 - 467.
Vancouver	zehir r,Karabay C,KALAYCI A,AKGÜN T,kılıçgedik a,KIRMA C Evaluation of Tpe interval and Tpe/QT ratio in patients with slow coronary flow. . 2015; 463 - 467.
IEEE	zehir r,Karabay C,KALAYCI A,AKGÜN T,kılıçgedik a,KIRMA C "Evaluation of Tpe interval and Tpe/QT ratio in patients with slow coronary flow." , ss.463 - 467, 2015.
ISNAD	zehir, regayip vd. "Evaluation of Tpe interval and Tpe/QT ratio in patients with slow coronary flow". (2015), 463-467.

APA	zehir r, Karabay C, KALAYCI A, AKGÜN T, kılıçgedik a, KIRMA C (2015). Evaluation of Tpe interval and Tpe/QT ratio in patients with slow coronary flow. The Anatolian Journal of Cardiology, 15(6), 463 - 467.
Chicago	zehir regayip,Karabay Can Yucel,KALAYCI Arzu,AKGÜN Taylan,kılıçgedik alev,KIRMA Cevat Evaluation of Tpe interval and Tpe/QT ratio in patients with slow coronary flow. The Anatolian Journal of Cardiology 15, no.6 (2015): 463 - 467.
MLA	zehir regayip,Karabay Can Yucel,KALAYCI Arzu,AKGÜN Taylan,kılıçgedik alev,KIRMA Cevat Evaluation of Tpe interval and Tpe/QT ratio in patients with slow coronary flow. The Anatolian Journal of Cardiology, vol.15, no.6, 2015, ss.463 - 467.
AMA	zehir r,Karabay C,KALAYCI A,AKGÜN T,kılıçgedik a,KIRMA C Evaluation of Tpe interval and Tpe/QT ratio in patients with slow coronary flow. The Anatolian Journal of Cardiology. 2015; 15(6): 463 - 467.
Vancouver	zehir r,Karabay C,KALAYCI A,AKGÜN T,kılıçgedik a,KIRMA C Evaluation of Tpe interval and Tpe/QT ratio in patients with slow coronary flow. The Anatolian Journal of Cardiology. 2015; 15(6): 463 - 467.
IEEE	zehir r,Karabay C,KALAYCI A,AKGÜN T,kılıçgedik a,KIRMA C "Evaluation of Tpe interval and Tpe/QT ratio in patients with slow coronary flow." The Anatolian Journal of Cardiology, 15, ss.463 - 467, 2015.
ISNAD	zehir, regayip vd. "Evaluation of Tpe interval and Tpe/QT ratio in patients with slow coronary flow". The Anatolian Journal of Cardiology 15/6 (2015), 463-467.