Maqsood Alam et al. Eduardo Sanhueza Adrian Baranchuk
It is with profound interest that we read the manuscript by Karahan et al. titled “Evaluation of Frontal QRS-T Angle in Patients with Coronary Artery Ectasia” published in the recent volume of International Journal of Cardiovascular Sciences . Coronary artery ectasia (CAE), a condition marked by focal enlargement of coronary arteries, has long intrigued researchers and clinicians due to its enigmatic nature. Beyond its silence existence, CAE hides a spectrum of clinical ranges, from chest pain with coexisting coronary artery disease to life threatening arrhythmias and sudden cardiac death. , While previous research has delved into the multifaceted etiology of CAE, , this study took a unique path, exploring the electrocardiographic landscape to better understand ventricular heterogeneity in CAE.
The cornerstone of this study lies in the evaluation of frontal QRS-T angle, a marker of ventricular repolarization heterogeneity. Spatial QRS-T angles have received attention in previous research, often as an indicator of worse cardiovascular outcomes. This method is a little tiresome, as it requires a 3-dimensional computational model for interpretation, whereas the ease of measurement of the frontal QRS-T angle from routine 12-lead electrocardiograms makes it an attractive alternative candidate for exploring ventricular repolarization. The frontal QRS-T angle was calculated as the absolute value of difference between the QRS- and T-axis, yielding values between 0° and 180°, and it was categorized as normal (≤ 90° ) or abnormal (≥ 100°). However, its application in the context of CAE is a novel and compelling avenue of investigation.
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