1
|
Is there a relationship between epicardial fat tissue thickness and Tp-Te/QT ratio in healthy individuals? ACTA ACUST UNITED AC 2020; 5:e127-e139. [PMID: 32665987 PMCID: PMC7339868 DOI: 10.5114/aoms.2020.96147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 04/10/2020] [Indexed: 11/17/2022]
Abstract
Introduction Epicardial fat is a tissue that releases many proinflammatory and atherogenic mediators, with endocrine and paracrine effects on the heart. In this study, the implication of the EFT thickness (EFTt) on transmural dispersion of repolarisation (TDR) was analysed utilizing the T-wave peak to end interval (Tp-Te), the Tp-Te dispersion (Tp-Te (d)), and the Tp-Te/QT ratio. Material and methods One thousand seven hundred and thirteen subjects were enrolled in the research. The subjects were chosen to be healthy individuals, without any cardiovascular/systemic disorders or risk factors for atherosclerosis. Transthoracic echocardiography (TTE) was applied to all subjects, and EFTt was measured in both diastole and systole. The ECG measurements were taken from standard 12-lead surface ECG. Results Correlation analysis revealed that the EFTt is highly associated with the Tp-Te interval, Tp-Te/QT ratio, Tp-Te (d), increasing age, body mass index (BMI), body surface area (BSA), left ventricular (LV) mass, LV mass index, plasma glucose during fasting, triglycerides, and low-density lipoprotein cholesterol. Conclusions The study results showed that increased EFTt was associated with increased TDR values of Tp-Te, Tp-Te (d), and Tp-Te/QT ratio, even in the absence of other factors that could increase TDR and EFTt. Therefore, it can be stated that increased EFTt may cause an increase the risk for ventricular arrhythmia.
Collapse
|
2
|
Augusto Fragata Filho A, da Silva Fragata C, Maria Lourenço A, Castro Faccini C, Ítalo Dias França J. Evaluation of Tpeak–Tend and QT intervals in Chagas’ Disease, Chronic Phase and Normal Electrocardiogram. JOURNAL OF CARDIAC ARRHYTHMIAS 2020. [DOI: 10.24207/jca.v32n4.3294_in] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Introduction: Chagas’ disease lacks elements to predict which carriers will evolve into cardiac form and which will remain in undetermined form. Objective: To evaluate the relationship between electrocardiographic evolution and Tpeak–Tend and QT intervals, both corrected for heart rate, in chagasic patients with normal initial electrocardiogram. Method: Chagasic patients admitted to the institution until 2002 were retrospectively evaluated, and the electrocardiogram was normal at the first consultation. The Tpeak–Tend and QT intervals were measured in milliseconds at the V2 and V5 derivations, with the mean values corrected for heart rate (Bazett). The relationship of these values with the electrocardiographic evolution of the individuals was analyzed, considering the gender, time of evolution and whether they received benznidazole or not. Results: The corrected Tpeak–Tend interval showed no statistical significance among those who maintained or not normal electrocardiogram. The corrected QT interval, the treatment with benznidazole and the time of evolution showed significance for the maintenance of normal electrocardiogram. In the multivariate evaluation, treatment with benznidazole, the QTc interval and the time of evolution were independent variables for the maintenance of normal electrocardiogram. Conclusion: The Tpeak–Tend interval showed no predictor of electrocardiographic evolution. The increased QT interval favored changes.
Collapse
Affiliation(s)
| | - Claudia da Silva Fragata
- Instituto Dante Pazzanese de Cardiologia – Laboratório de Doença de Chagas – São Paulo (SP), Brazil
| | - Angela Maria Lourenço
- Instituto Dante Pazzanese de Cardiologia – Laboratório de Doença de Chagas – São Paulo (SP), Brazil
| | - Cristiane Castro Faccini
- Instituto Dante Pazzanese de Cardiologia – Laboratório de Doença de Chagas – São Paulo (SP), Brazil
| | - João Ítalo Dias França
- Instituto Dante Pazzanese de Cardiologia – Laboratório de Doença de Chagas – São Paulo (SP), Brazil
| |
Collapse
|
3
|
Augusto Fragata Filho A, da Silva Fragata C, Maria Lourenço A, Castro Faccini C, Ítalo Dias França J. Avaliação do Intervalo Tpico–Tfim e QT em Doença de Chagas, Fase Crônica e Eletrocardiograma Normal. JOURNAL OF CARDIAC ARRHYTHMIAS 2020. [DOI: 10.24207/jca.v32n4.3294_pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Introdução: A doença de Chagas carece de elementos que proporcionem prever quais portadores evoluirão para a forma cardíaca e quais permanecerão na forma indeterminada. Objetivo:Avaliar relação entre evolução eletrocardiográfica e intervalos Tpico–Tfim e QT, ambos corrigidos para a frequência cardíaca, em chagásicos com eletrocardiograma inicial normal. Método: Avaliamos retrospectivamente chagásicos admitidos na instituição até 2002, tendo eletrocardiograma normal na primeira consulta. Os intervalos Tpico–Tfim e QT foram medidos em milissegundos nas derivações V2 e V5, sendo a média dos valores corrigida para a frequência cardíaca (Bazett). Analisou-se a relação desses valores com a evolução eletrocardiográfica dos indivíduos, tendo em vista sexo, tempo de evolução e se receberam benzonidazol ou não. Resultados: O intervalo Tpico–Tfim corrigido não mostrou significância estatística entre os que mantiveram ou não eletrocardiograma normal. O intervalo QT corrigido, o tratamento com benzonidazol e o tempo de evolução mostraram significância quanto à manutenção do eletrocardiograma normal. Na avaliação multivariada, o tratamento com benzonidazol, o intervalo QTc e o tempo de evolução se mostraram variáveis independentes para a manutenção do eletrocardiograma normal. Conclusão:O intervalo Tpico–Tfim não se mostrou preditor da evolução eletrocardiográfica. O intervalo QT aumentado favoreceu aparecimento de alterações.
Collapse
Affiliation(s)
| | - Claudia da Silva Fragata
- Instituto Dante Pazzanese de Cardiologia – Laboratório de Doença de Chagas – São Paulo (SP), Brazil
| | - Angela Maria Lourenço
- Instituto Dante Pazzanese de Cardiologia – Laboratório de Doença de Chagas – São Paulo (SP), Brazil
| | - Cristiane Castro Faccini
- Instituto Dante Pazzanese de Cardiologia – Laboratório de Doença de Chagas – São Paulo (SP), Brazil
| | - João Ítalo Dias França
- Instituto Dante Pazzanese de Cardiologia – Laboratório de Doença de Chagas – São Paulo (SP), Brazil
| |
Collapse
|
4
|
Kazemi B, Hajizadeh R, Ranjbar A, Sohrabi B, Vaezi H. Evaluation of T peak to end/QT and T peak to end/QTc ratios in patients with STEMI undergoing percutaneous intervention vs. thrombolytic therapy. J Electrocardiol 2020; 58:160-164. [PMID: 31895992 DOI: 10.1016/j.jelectrocard.2019.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 11/15/2019] [Accepted: 12/03/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The patients with ST-segment Elevation Myocardial Infarction (STEMI) are significantly at increased risk of arrhythmia. Repolarization of myocardium has been evaluated by a series of electrical parameters including T wave peak to T wave end (Tp-Te) and Tp-Te/QT ratio. Which were compared with survival outcomes between two groups of STEMI patients treated with Primary Percutaneous Coronary Intervention (PPCI) and recombinant Tissue Plasminogen Activator (r-TPA). METHODS In this prospective study, 188 patients with STEMI were included in the study. 12‑Lead ECGs were obtained from all patients on time of admission and after 24 h after treatment. After dividing the patients into two groups based on their type of treatment (PPCI or r-TPA), The Tp-Te/QT and Tp-Te/QTc ratios were calculated using ECG records. The survival outcomes were compared between two groups. RESULTS 95 patients (50.5%) underwent PPCI and 93 patients (49.5%) received r-TPA. Tp-Te/QT and Tp-Te/QTc ratios after administration of the treatments were significantly decreased in both groups (P-value = .001) with lower Tp-Te/QT and Tp-Te/QTc ratios in PPCI group (P-value = .001). 7 patients in PPCI group (7.3%) and 16 patients in r-TPA group (17.2%) were died during their hospitalization period (P-value = .04). The best combination of sensitivity and specificity of post treatment Tp-Te/QT ratio was at cutoff points of 29.4 with 82% sensitivity and 83% specificity. CONCLUSION Our study demonstrated that Tp-Te/QT and Tp-Te/QTc ratios decrease significantly after both PPCI and r-TPA therapies, but with PPCI these indexes decrease more than r-TPA, resulting a better survival outcome in patients with STEMI.
Collapse
Affiliation(s)
- Babak Kazemi
- Department of Cardiology, Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
| | - Reza Hajizadeh
- Department of Cardiology, Faculty of Medicine, Urmia University of Medical Science, Urmia, Iran
| | - Abdolmohammad Ranjbar
- Department of Cardiology, Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran.
| | - Bahram Sohrabi
- Department of Cardiology, Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
| | - Hasanali Vaezi
- Department of Cardiology, Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
| |
Collapse
|
5
|
Miceli F, Presta V, Citoni B, Canichella F, Figliuzzi I, Ferrucci A, Volpe M, Tocci G. Conventional and new electrocardiographic criteria for hypertension-mediated cardiac organ damage: A narrative review. J Clin Hypertens (Greenwich) 2019; 21:1863-1871. [PMID: 31693279 DOI: 10.1111/jch.13726] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/25/2019] [Accepted: 10/07/2019] [Indexed: 01/24/2023]
Abstract
Hypertension-mediated organ damage (HMOD) is frequently observed in hypertensive patients at different cardiovascular (CV) risk profile. This may have both diagnostic and therapeutic implications for the choice of the most appropriate therapies. Among different markers of HMOD, the most frequent functional and structural adaptations can be observed at cardiac level, including left ventricular hypertrophy (LVH), diastolic dysfunction, aortic root dilatation, and left atrial enlargement. In particular, LVH was shown to be a strong and independent risk factor for major CV events, namely myocardial infarction, stroke, congestive heart failure, CV death. Thus, early identification of LVH is a key element for preventing CV events in hypertension. Although echocardiographic assessment of LVH represents the gold standard technique, this is not cost-effective and cannot be adopted in routine clinical practice of hypertension. On the other hand, electrocardiographic (ECG) assessment of HMOD relative to the heart is a simple, reproducible, widely available and cost-effective method to assess the presence of LVH, and could be preferred in large scale screening tests. Several new indicators have been proposed and tested in observational studies and clinical trials of hypertension, in order to improve the relatively low sensitivity of the conventional ECG criteria for LVH, despite high specificity. This article reviews the differences in the use of the main conventional and the new 12 lead ECG criteria of LVH for early assessment of asymptomatic, subclinical cardiac HMOD in a setting of clinical practice of hypertension.
Collapse
Affiliation(s)
- Francesca Miceli
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Vivianne Presta
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Barbara Citoni
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Flaminia Canichella
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Ilaria Figliuzzi
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Andrea Ferrucci
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Massimo Volpe
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy.,IRCCS Neuromed, Pozzilli, Isernia, Italy
| | - Giuliano Tocci
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy.,IRCCS Neuromed, Pozzilli, Isernia, Italy
| |
Collapse
|
6
|
Son O, Boduroglu Y. Comparing of Tp-Te Interval and Tp-Te/Qt Ratio in Patients with Preserved, Mid-Range and Reduced Ejection Fraction Heart Failure. Open Access Maced J Med Sci 2019; 7:752-759. [PMID: 30962833 PMCID: PMC6447328 DOI: 10.3889/oamjms.2019.186] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Heart failure (HF) is classified in three class: HF with preserved EF (HFpEF); normal or LVEF ≥ 50%, HF with reduced EF (HFrEF); LEVF < 40% and newly HF mid-range EF (HFmrEF); LVEF 40-49%. On Electrocardiography (ECG) T wave, Tpeak-Tend (Tp-Te) interval reflects transmural dispersion of repolarisation (TDR) which of these indexes have been proposed as predictors of risk for ventricular arrhythmia (VA) in many cardiac diseases. AIM Aim of this study to asses these indices of TDR among three HF class. METHODS Total of 192 patients were included in this study. RESULTS Many of indices like Tp-Te, Tp-Te/QT wasn't different between groups (P > 0.05). But mean Q-Tpeak (QTp), S-Tend (S-Te) and S-Tpeak (S-Tp) were found significantly different between groups (P < 0.05). Again S-Te was found different according to having fragmented QRS (fQRS) on ECG (P = 0.031). Comparing to mitral inflow E/A parameters showed significant differences for Tp-Te, Tp-Tec, Tp-Te/QT, Tp-Te/QTc and Tp-Tec/QTc parameters. Finally, we found correlations between S-Te and white blood cell (WBC) (r = - 0.171; P = 0.037) and S-Tp and WBC (r = - 0.170; P = 0.038) and between S-Te and fQRS (r = 0.158; P = 0.031). CONCLUSIONS We didn't find differences for many of indices of TDR like Tp-Te interval between groups except QTp, S-Te, S-Tp intervals. Also, S-Te and fQRS showed significant correlation. For prediction of ventricular arrhythmia and cardiovascular death newer indexes on ECG are needed to be established in the future which will make us facilitate to distinguish high risk patients.
Collapse
Affiliation(s)
- Osman Son
- Department of Endocrinology, Private Acibadem Hospital, Eskisehir, Turkey
| | - Yalcin Boduroglu
- Department of Cardiology, Ahi Evran University Education and Research Hospital, Kirsehir, Turkey
| |
Collapse
|
7
|
Yılmaz M, Dağlı MN, Uku Ö, Bilen MN, Korkmaz H, Erdem K, Kurtoğlu E. Focusing on a complete blood cell parameter: mean platelet volume levels may be a predictor of coronary slow flow. Vasc Health Risk Manag 2017; 13:255-261. [PMID: 28740398 PMCID: PMC5508812 DOI: 10.2147/vhrm.s126105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The relationship between increased mean platelet volume (MPV) and atherosclerosis is well known. In the present study, MPV in patients with coronary slow flow (CSF) and in cases with normal coronary anatomy (NCA) was investigated and compared with the aim of identifying the relationship between CSF and MPV. Patients and methods We studied 40 patients previously determined via coronary angiography as having NCA and 40 patients with CSF in the coronary blood stream, as identified by thrombolysis in myocardial infarction square. Thus, a total of 80 patients from the Elaziğ Education and Research Hospital (Elaziğ, Turkey) were included in the present study retrospectively and laboratory and anamnesis information was scanned into their files. The relationship between MPV and CSF was studied. Results MPV levels were observed to be significantly higher in the CSF group compared to the NCA group (10.05±1.3 and 8.6±0.6, p<0.001). In receiver operating characteristics analyses, it was determined that an MPV >9.05 measured in CSF patients at application had a predictive specificity of 77.5% and sensitivity of 77.5% for CSF (area under the curve: 0.825, 95% confidence interval [CI]: 0.726–0.924, p<0.0001). It was found that MPV level was an independent predictor of CSF (β=−600, p<0.001, 95% CI: −0.383 to −0.176). Conclusion MPV is increased in patients with CSF when compared to patients with NCA. This finding supports the fact that MPV could be a predictor of CSF.
Collapse
Affiliation(s)
- Mücahid Yılmaz
- Department of Cardiology, Elazığ Education and Research Hospital
| | | | - Ökkeş Uku
- Department of Cardiology, Elazığ Education and Research Hospital
| | | | - Hasan Korkmaz
- Department of Cardiology, FIRAT University School of Medicine, Elazığ
| | - Kenan Erdem
- Department of Cardiology, Sivas Hospital State, Sivas, Turkey
| | | |
Collapse
|
8
|
Coronary slow flow: Benign or ominous? Anatol J Cardiol 2016; 16:71-2. [PMID: 26854681 PMCID: PMC5336717 DOI: 10.14744/anatoljcardiol.2015.6777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|