Electrocardiographic predictors of coronary microvascular dysfunction in patients with non-obstructive coronary artery disease: Utility of a novel T wave analysis program
Language English Country Netherlands Media print-electronic
Document type Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't
Grant support
AG-31750
NIA NIH HHS - United States
HL-92954
NHLBI NIH HHS - United States
PubMed
26580336
DOI
10.1016/j.ijcard.2015.10.228
PII: S0167-5273(15)30795-6
Knihovny.cz E-resources
- Keywords
- Coronary microvascular dysfunction, Non-obstructive coronary artery disease, QT interval prolongation, T wave morphology, Ventricular arrhythmia,
- MeSH
- Electronic Data Processing methods MeSH
- Electrocardiography methods MeSH
- Ultrasonography, Interventional MeSH
- Coronary Angiography MeSH
- Coronary Vessels physiopathology MeSH
- Coronary Circulation physiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Microcirculation physiology MeSH
- Follow-Up Studies MeSH
- Coronary Artery Disease diagnosis physiopathology MeSH
- Reproducibility of Results MeSH
- Retrospective Studies MeSH
- Blood Flow Velocity MeSH
- Software * MeSH
- Severity of Illness Index MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Research Support, N.I.H., Extramural MeSH
BACKGROUND: Coronary microvascular dysfunction (CMD) is linked to adverse cardiovascular events. Definitive diagnosis of CMD requires invasive provocative testing during angiography. We developed and tested a novel computerized T wave analysis tool to identify electrocardiographic signatures of CMD. METHODS: 1552 patients underwent an invasive assessment of coronary microvascular function. Patients with interpretable pre-procedural ECGs were divided into 2 age and sex matched groups (n=261 in each group, 75% female): normal microvascular function, CFR>2.5 (CFR+), and abnormal microvascular function, CFR ≤ 2.5 (CFR-). ECGs were evaluated using a novel T wave program that quantified subtle changes in T wave morphology. RESULTS: T wave repolarization parameters were significantly different between patients with normal and abnormal microvascular function. The top 3 features in males comprised of T wave area in V6 (CFR+: 10091.4 mV(2) vs. CFR-: 8152.3 mV(2), p<0.05); T1 Y-center of gravity in lead II (CFR+: 17.8 mV vs. CFR-: 22.4, p<0.005) and T Peak-T End in lead II (CFR+: 97.6 msec vs. CFR-: 91.1 msec, p<0.05). These could identify the presence of an abnormal CFR with 74 ± 0.2% accuracy. In females, the top 3 features were T wave right slope lead V6 (CFR+: -2489.1 mV/msec vs. CFR-: -2352.3 mV/msec, p<0.005); Amplitude in V6 (CFR+: 190.4 mV vs. 172.7 mV, p=0.05) and Y-center of gravity in lead V1 (CFR+: 33.3 vs. CFR-: 40.0, p=0.001). These features could identify the presence of an abnormal CFR with 67 ± 0.3% accuracy. CONCLUSION: Our data demonstrates that a computer-based repolarization measurement tool may identify electrocardiographic signatures of CMD.
Division of Cardiovascular Diseases Mayo College of Medicine Rochester MN USA
Division of Internal Medicine Mayo College of Medicine Rochester MN USA
Electrical and Computer Engineering Ben Gurion University of the Negev Beer Sheva Israel
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