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

IF 2.6 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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预测心肌灌注SPECT中可逆性缺血的心电图参数：一项病例对照研究

背景心肌灌注单光子发射计算机断层扫描（SPECT）和心电图（ECG）是临床上评价冠状动脉疾病（CAD）的重要手段。目的探讨心室复极参数、基础心电图电生理平衡指数（iCEB）与SPECT可逆性缺血表现之间的关系。方法将可逆性缺血患者45例（99mTc-MIBI）应力-静息心肌灌注SPECT及冠心病冠状动脉造影证实为缺血组。45名扫描正常的患者，按年龄和性别与缺血患者组相匹配，被纳入对照组。为期两天的99mTc-MIBI SPECT方案在腺苷-药物应激下进行。记录缺血组的缺血情况和可逆缺血大小（RIS）。记录缺血组和对照组总应激评分（SSS）。计算QRS、QTd、cQTd、Tp-Te、Tp-Te/QT、Tp-Te/cQT、iCEB （QT/QRS）、iCEBc （cQT/QRS）。采用Spearman试验评价心肌灌注SPECT与心电图参数的相关性。采用logistic回归分析评估可逆性缺血的预测因素。结果缺血组QRS持续时间（p = 0.018）、cQTmax （p = 0.006）、QTd （p = 0.002）、cQTd （p = 0.003）显著高于缺血组。缺血组Tp-Te （p = 0.004）、Tp-Te/QT比值（p = 0.003）、Tp-Te/cQT比值（p = 0.002）均显著降低。多因素分析显示，高脂血症、QRS持续时间、cQTd和Tp-Te/QTc比值是缺血的独立预测因子。结论Tp-Te/cQT比值、QRS持续时间、cQTd可能是SPECT可逆性缺血的重要预测指标，值得进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.