ECG-derived DETERMINE score can provide information about procedure success in chronic total occlusion patients

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology Pub Date : 2025-05-11 DOI:10.1016/j.jelectrocard.2025.154022

Muzaffer Kahyaoğlu MD, Büşra Güvendi Şengör MD, Müge Ildızlı Demirbaş MD, Çetin Geçmen MD, Elnur Alizade MD, Regayip Zehir MD, Ali Karagöz MD

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引用次数: 0

Abstract

Background

Successful chronic total occlusion (CTO) interventions may provide symptomatic relief, improve left ventricular ejection fraction (LVEF), and improve clinical outcomes. In contrast, unsuccessful interventions may increase major adverse cardiovascular event rates. Several studies have investigated various scoring systems used to predict procedural success. The DETERMINE score is an electrocardiography (ECG) score that includes Q waves, fragmented QRS, and T wave inversions. This study aimed to investigate the relationship between the procedural success of CTO and the ECG-derived DETERMINE score system.

Methods

Our study included 301 patients. The patients were divided into successful revascularization (69 %) and unsuccessful revascularization (31 %).

Results

The unsuccessful revascularization group had a higher history of coronary artery disease, lower glomerular filtration rate (GFR) levels, lower left LVEF, higher j-CTO score, less good coronary collateral, higher retrograde approach, longer QRS interval, longer QT and QTc interval, and higher DETERMINE score than the successful revascularization group. The multivariate logistic regression test results indicated LVEF, j-CTO score, absence of good coronary collateral, and DETERMINE score as independent predictive parameters for unsuccessful revascularization.

Conclusion

Predicting procedural success in CTO patients is crucial, especially when selecting patients. The DETERMINE score, obtained from the ECG, may aid in decision-making.

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心电图得出的确定评分可以提供慢性全闭塞患者手术成功的信息

成功的慢性全闭塞（CTO）干预可以缓解症状，改善左心室射血分数（LVEF），改善临床结果。相反，不成功的干预可能会增加主要不良心血管事件的发生率。几项研究调查了用于预测手术成功的各种评分系统。确定评分是一种心电图评分，包括Q波、碎片QRS和T波反转。本研究旨在探讨CTO手术成功与心电图衍生的确定评分系统之间的关系。方法本研究纳入301例患者。患者分为血运重建成功（69%）和血运重建不成功（31%）。结果与血运重建成功组相比，血运重建失败组有较高的冠状动脉病史，较低的肾小球滤过率（GFR）水平，较低的左LVEF，较高的j-CTO评分，较少的良好冠状动脉侧支，较高的逆行入路，较长的QRS间期，较长的QT和QTc间期，以及较高的decision评分。多因素logistic回归检验结果显示，LVEF、j-CTO评分、无良好冠状动脉侧枝和decision评分是血运重建失败的独立预测参数。结论预测CTO患者的手术成功率至关重要，尤其是在选择患者时。从心电图中获得的确定评分可能有助于决策。

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

Journal of electrocardiology 医学-心血管系统

CiteScore

2.70

自引率

7.70%

发文量

152

审稿时长

38 days

期刊介绍： The Journal of Electrocardiology is devoted exclusively to clinical and experimental studies of the electrical activities of the heart. It seeks to contribute significantly to the accuracy of diagnosis and prognosis and the effective treatment, prevention, or delay of heart disease. Editorial contents include electrocardiography, vectorcardiography, arrhythmias, membrane action potential, cardiac pacing, monitoring defibrillation, instrumentation, drug effects, and computer applications.