Atrial and ventricular arrhythmia predictors with electrocardiographic parameters in myocardial infarction with non-obstructive coronary artery disease (MINOCA).
Serkan Asil, Muhammet Geneş, Salim Yaşar, Serdar Fırtına, Suat Görmel, Erkan Yıldırım, Yalçın Gökoğlan, Hatice Tolunay, Barış Buğan, Ayşe Saatçi Yaşar, Murat Çelik, Uygar Çağdaş Yüksel, Cem Barçın, Hasan Kutsi Kabul
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引用次数: 0
Abstract
Background: The clinical importance and recognition of myocardial infarction with non-obstructive coronary artery disease (MINOCA) is increasing. Nevertheless, no studies are investigating the risk of atrial fibrillation and ventricular arrhythmia in MINOCA patients. This study aimed to determine the risk of arrhythmia with electrocardiographic predictors in MINOCA patients.
Methods: In this study, patients diagnosed with MINOCA and stable out-patients without significant lesions in their coronary arteries were compared. Morphology-voltage-Pwave duration electrocardiography (MPV ECG) score was used to determine atrial arrhythmia risk. QT interval and QT dispersion Tpeak-Tend time and Tpeak-Tend/QT interval were used to determine ventricular arrhythmia risk.
Results: A total of 155 patients were included in our study. Seventy-seven of these patients were in the MINOCA group. There was no statistically significant difference between the two groups in MPV ECG score (1.95 ± 1.03 vs 1.68 ± 1.14, p = 0.128). P-wave voltage, P-wave morphology and P-wave duration, which are components of the MPV ECG score, were not statistically significantly different. The QRS complex duration (90.21 ± 14.87 vs 82.99 ± 21.59 ms, p = 0.017), ST interval (271.95 ± 45.91 vs 302.31 ± 38.40 ms, p < 0.001), corrected QT interval (438.17 ± 43.80 vs 421.41 ± 28.39, p = 0.005) and QT dispersion (60.75 ± 22.77 vs 34.19 ± 12.95, p < 0.001) were statistically significantly higher in the MINOCA group. The Tpeak-Tend (89.53 ± 32.16 vs 65.22 ± 18.11, p < 0.001), Tpeak-Tend/QT interval (0.2306 ± 0.0813 vs 0.1676 ± 0.0470, p < 0.001) and Tpeak-Tend/corrected QT interval (0.2043 ± 0.6997 vs 0.1551 ± 0.4310, p < 0.001) ratios were also significantly higher in patients with MINOCA.
Conclusions: In the MINOCA patients, there was no increase in the risk of atrial fibrillation based on ECG predictors. However, it was shown that there could be a significant increase in the risk of ventricular arrhythmia. We believe this study could be helpful for specific recommendations concerning duration of hospitalisation and follow up in MINOCA patients.
背景：心肌梗死合并非阻塞性冠状动脉疾病（MINOCA）的临床重要性和认识正在提高。然而，没有研究调查MINOCA患者发生心房颤动和室性心律失常的风险。本研究旨在通过心电图预测指标确定MINOCA患者心律失常的风险。方法：在本研究中，对诊断为MINOCA的患者和冠状动脉无明显病变的稳定患者进行比较。形态电压波形持续时间心电图（MPV ECG）评分用于确定心房心律失常的风险。QT间期和QT离散度Tpeak-Tend时间和Tpeak-Tend/QT间期用于确定室性心律失常的风险。结果：本研究共纳入155例患者。其中77名患者属于MINOCA组。两组MPV心电图评分无统计学差异（1.95±1.03 vs 1.68±1.14，p=0.128）。构成MPV心电图得分的p波电压、p波形态和p波持续时间无统计学差异。MINOCA组的QRS波群持续时间（90.21±14.87 vs 82.99±21.59 ms，p=0.017）、ST间期（271.95±45.91 vs 302.31±38.40 ms，p<0.001）、校正QT间期（438.17±43.80 vs 421.41±28.39，p=0.005）和QT离散度（60.75±22.77 vs 34.19±12.95，p<0.005）在统计学上显著高于MINOCA。MINOCA患者的Tpeak-Tend（89.53±32.16 vs 65.22±18.11，p＜0.001）、Tpeak-Tend/QT间期（0.2306±0.0813 vs 0.1676±0.0470，p＜0.01）和Tpeak-Tend/校正QT间期（0.2043±0.6997 vs 0.1551±0.4310，p＜001）比值也显著升高，根据心电图预测，心房颤动的风险没有增加。然而，研究表明，室性心律失常的风险可能会显著增加。我们相信这项研究可能有助于就MINOCA患者的住院时间和随访提出具体建议。
期刊介绍：
The Cardiovascular Journal of Africa (CVJA) is an international peer-reviewed journal that keeps cardiologists up to date with advances in the diagnosis and treatment of cardiovascular disease. Topics covered include coronary disease, electrophysiology, valve disease, imaging techniques, congenital heart disease (fetal, paediatric and adult), heart failure, surgery, and basic science.
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