QT interval dispersion analysis in acute myocardial infarction patients: coronary reperfusion effect
Neuza Helena Moreira Lopes et al. César Grupi Cleberson H. Dina Aécio F. T. de Gois … Ludhmila A. Hajjar Beatriz Ayub Carlos Eduardo Rochitte José Antonio Franchini Ramires Whady A. Hueb Roberto Kalil
OBJECTIVE: To study the effect of early reperfusion of infarct-related artery on QT(deltaQT) dispersion interval, as well as how valuable it is as a marker for coronary reperfusion and ventricular arrhythmias. METHODS: One hundred and six patients with reperfusion (WR) and 48 without reperfusion (WtR) who have received thrombolytic therapy in the acute phase of infarction were studied. ECG carried out on admission as well as on day 4 of patient’s course were analyzed. deltaQT – defined as the difference between maximum and minimum QT interval – was measured by 12-lead ECG. RESULTS: The reperfusion group showed significant deltaQT reduction – from 89.66±20,47ms down to 70.95±21.65ms (p<0.001). On the other hand, the group without reperfusion showed deltaQT significant increase – from 81.27±20.52ms up to 91.85±24.66ms (p<0.001). Logistic regression analysis showed that reduction magnitude beween pre- and post-thrombolysis deltaQT was the independent factor to most effectively identify coronary reperfusion (OR 1.045, p<0.0001; CI 95%). No significant difference was found in dispersion measures when patients with ventricular arrhythmias were compared with those with no arryhthmias in the course of the first 48 hours. CONCLUSION: The study shows that deltaQT is significantly reduced in patients with acute myocardial infarction submitted to successful thrombolysis, and is increased in infarcted patients with closed artery. deltaQT reduction between the pre- and post-thrombolysis condition was a predictor for coronary reperfusion of those patients, and did not show correlation to ventricular arrhythmias.