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QT dispersion plus ST-segment depression: a new predictor of restenosis after successful percutaneous transluminal coronary angioplasty.

Abstract：

BACKGROUND:ST-segment depression during exercise testing is frequently observed in the absence of restenosis after percutaneous transluminal coronary angioplasty (PTCA). HYPOTHESIS:With the goal of improving the prediction of restenosis after PTCA, we evaluated the usefulness of ST-segment depression plus QT dispersion (QTd = QTmax - QTmin) during treadmill stress test. METHODS AND RESULTS:Fifty-six patients (37 men, 19 women, mean age 51 +/- 14 years) were evaluated with treadmill exercise testing and coronary angiography 7 +/- 5 months after PTCA. Treadmill test was positive in 30 patients and negative in 26 patients. At coronary angiography, restenosis was present in 16 patients with positive exercise electrocardiogram (ECG) and in 6 patients with negative exercise ECG. Fourteen patients with a positive stress test did not have restenosis. There was no difference in QTd values between groups at baseline (p > 0.05). Exercise QTd was 63 +/- 9 ms in patients with positive exercise test, 54 +/- 18 ms in patients with negative exercise test (p = 0.003), 71 +/- 13 ms in patients with restenosis, and 53 +/- 17 ms in patients without restenosis (p = 0.001). ST-segment depression during the stress test determined restenosis with a sensitivity of 80% and a specificity of 58%. Sensitivity and specificity of QTd of > or = 60 ms for prediction of restenosis were 83 and 61%, respectively. When QTd of > or = 60 ms was added to ST-segment depression as a condition for positive test, the sensitivity and specificity increased to 91 and 78%, respectively. QT dispersion plus ST-segment depression had higher sensitivity and specificity than either QTd or ST-segment depression alone (p < 0.05). CONCLUSION:The addition of QTd to ST-segment depression during exercise test improves the diagnostic value and can be used as a noninvasive tool in the diagnosis of restenosis after PTCA.

journal_name

Clin Cardiol

journal_title

Clinical cardiology

authors

Aytemir K,Ozer N,Aksöyek S,Ozkutlu H,Oto A,Ozmen F

doi

10.1002/clc.4960220608

subject

Has Abstract

pub_date

1999-06-01 00:00:00

pages

409-12

issue

eissn

0160-9289

issn

1932-8737

journal_volume

pub_type

杂志文章

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QT dispersion plus ST-segment depression: a new predictor of restenosis after successful percutaneous transluminal coronary angioplasty.