Electrocardiographic predictors of coronary microvascular dysfunction in patients with non-obstructive coronary artery disease: Utility of a novel T wave analysis program
Jazyk angličtina Země Nizozemsko Médium print-electronic
Typ dokumentu časopisecké články, Research Support, N.I.H., Extramural, práce podpořená grantem
Grantová podpora
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-zdroje
- Klíčová slova
- Coronary microvascular dysfunction, Non-obstructive coronary artery disease, QT interval prolongation, T wave morphology, Ventricular arrhythmia,
- MeSH
- automatizované zpracování dat metody MeSH
- elektrokardiografie metody MeSH
- intervenční ultrasonografie MeSH
- koronární angiografie MeSH
- koronární cévy patofyziologie MeSH
- koronární cirkulace fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mikrocirkulace fyziologie MeSH
- následné studie MeSH
- nemoci koronárních tepen diagnóza patofyziologie MeSH
- reprodukovatelnost výsledků MeSH
- retrospektivní studie MeSH
- rychlost toku krve MeSH
- software * MeSH
- stupeň závažnosti nemoci MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem 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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