Tpeak-Tend dispersion as a predictor for malignant arrhythmia events in patients with vasospastic angina

• Published in: International journal of cardiology Vol. 249; pp. 61 - 65
• Main Authors: Xianpei, Wang, Sha, Wu, Chuanyu, Gao, Juanjuan, Yan, Chong, Chen, Yongen, Shi, Yu, Feng, Zhenhao, Lin
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15-12-2017
• Subjects: Malignant arrhythmia events; Tp-e dispersion; Tp-e interval; Vasospastic angina; Tp-e interval; QTc; TdP; Brs; OR; TDR; VT/VF; Tp-e dispersion; CI; LQTS; ROC; Vasospastic angina; VA; Tp-e/QT; Malignant arrhythmia events; AUC; MAE; VIF; Tp-e; GDR; APD; SCD; STEMI; Tp-ec
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2017.07.093

Tpeak-Tend interval (Tp-e interval) in electrocardiogram (ECG) has been reported to predict malignant arrhythmia events (MAE) in ST-segment elevation myocardial infarction and ion channelopathy. Tp-e interval and other ECG parameters as predictors for MAE was evaluated in patients with vasospastic angina (VA).
Sixty-two patients with VA (Non-MAE group) and 20 patients with VA complicated by MAE (MAE group) were enrolled in our Division of Cardiology between January 2010 and December 2015. Continuous variables were analyzed by t-test and categorical variables by Chi-square analysis. Patients with MAE showed greater QTc (corrected QT interval) dispersion (P=0.005), Tp-ec (corrected Tp-e) interval (P=0.001), Tp-ec dispersion (P<0.001) and Tp-e/QT ratio (P<0.001) than those in non-MAE groups when ST-segment elevated. After elevated ST-segment returned, there were no significant differences in these ECG parameters between two groups (All P>0.05). At univariate binary logistic regression analysis QTc dispersion (odds ratio(OR)=1.133; P=0.013), Tp-ec (OR=1.058; P=0.003), Tp-e/QT (OR=1.403; P=0.001), and Tp-ec dispersion (OR=1.497; P=0.004) were significantly associated with MAE. At multivariable logistic regression analysis, Tp-ec dispersion remained a predictor of MAE. Receiver operating characteristic (ROC) curve analysis showed that only AUC (Area under curve) of Tp-ec dispersion had significant difference with those in QTc dispersion (P<0.001), Tp-ec (P=0.003), and Tp-e/QT ratio (P=0.012), respectively.
QTc dispersion, Tp-ec, Tp-e/QT and Tp-ec dispersion were significantly increased in VA patients with MAE than those without MAE when coronary spasm was onset. Prolonged Tp-ec dispersion was the best discriminators and a strong independent predictor of MAE in VA patients.