Electrocardiogram parameters in predicting reversible ischemia in myocardial perfusion SPECT: A case-control study

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung Pub Date : 2025-02-27 DOI:10.1016/j.hrtlng.2025.02.010

Seda Gülbahar Ateş , Hüseyin Emre Tosun , Gamze Tatar

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引用次数: 0

Abstract

Background

Myocardial perfusion single photon emission computed tomography (SPECT) and electrocardiogram(ECG) are crucial modalities in the evaluation of coronary artery disease(CAD) in clinical practice.

Objective

To evaluate the relationship between ventricular repolarization parameters, index of cardiac electrophysiological balance (iCEB) from basal electrocardiograms (ECG), and reversible ischemia findings on SPECT.

Methods

A total of 45 patients with reversible ischemia on 99m technetium-sestamibi (^99mTc-MIBI) stress-rest myocardial perfusion SPECT and confirmed CAD by coronary angiography were included in the ischemia group. Forty-five patients with normal scans, matched by age and gender with the ischemia patient group, were included in the control group. The two-day 99mTc-MIBI SPECT protocol was performed with adenosine-pharmacologic stress. The presence of ischemia and reversible ischemia size (RIS) were recorded in the ischemia group. The summed stress scores (SSS) were recorded for the ischemia and control groups. The QRS, QTd, cQTd, Tp-Te, Tp-Te/QT, Tp-Te/cQT, iCEB (QT/QRS), and iCEBc (cQT/QRS) were calculated. Correlations between myocardial perfusion SPECT and ECG parameters were evaluated using the Spearman test. Predictors of reversible ischemia were assessed using logistic regression analysis.

Results

The ischemia group showed significantly higher values for QRS duration (p = 0.018), cQTmax (p = 0.006), QTd (p = 0.002), and cQTd (p = 0.003). Tp-Te (p = 0.004), Tp-Te/QT ratio (p = 0.003), and Tp-Te/cQT ratio (p = 0.002) were significantly lower in the ischemia group. The multivariate analysis showed that hyperlipidemia, QRS duration, cQTd, and Tp-Te/QTc ratio were found as independent predictors of ischemia.

Conclusion

The Tp-Te/cQT ratio, QRS duration, and cQTd might be valuable predictors of reversible ischemia in SPECT, warranting further study.

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来源期刊

Heart & Lung 医学-呼吸系统

CiteScore

4.60

自引率

3.60%

发文量

184

审稿时长

35 days

期刊介绍： Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders. The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.