Prolonged Tpeak-end and Tpeak-end/QT ratio as predictors of malignant ventricular arrhythmias in the acute phase of ST-segment elevation myocardial infarction: A prospective case-control study

Jayaprakash Shenthar, Surender Deora, Maneesh Rai, Chollenhalli Nanjappa Manjunath

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background Prolonged Tpeak-end (the interval from the peak of the T wave to the end of the T wave) and Tpeak-end/QT ratio have been shown to be markers of arrhythmogenesis in various cardiac disorders. Objectives The purpose of this study was to evaluate the utility of Tpeak-end and Tpeak-end/QT ratio at admission in patients with acute ST-segment elevation myocardial infarction (STEMI) in predicting malignant ventricular arrhythmias. Methods The study group included 50 patients presenting with STEMI, in whom Tpeak-end and Tpeak-end/QT ratio were measured at admission; these patients were monitored for arrhythmias with a continuous electrocardiogram in the intensive care unit for 48 hours, and 50 healthy individuals acted as controls. Results The Tpeak-end (0.11 ± 0.04 seconds vs 0.08 ± 0.006 seconds; P <.0010) and Tpeak-end/QT ratio (0.30 ± 0.06 vs 0.21 ± 0.02; P <.001) were prolonged in patients with STEMI. Three patients with STEMI who sustained ventricular fibrillation (VF) within 24 hours of admission had prolonged corrected QT interval (0.39 ± 0.04 seconds vs 0.46 ± 0.13 seconds; P =.019), Tpeak-end (0.10 ± 0.02 seconds vs 0.20 ± 0.11 seconds; P <.001), and Tpeak-end/QT ratio (0.26 ± 0.05 vs 0.41 ± 0.09; P <.001) as compared with patients with STEMI without VF. Tpeak-end > 0.1 seconds and Tpeak-end/QT ratio > 0.3 predicted VF with a sensitivity of 100%. However, the Tpeak-end/QT ratio had a higher specificity (82.9% for Tpeak-end/QT ratio vs 44.7% for Tpeak-end) and accuracy (84% for Tpeak-end/QT ratio vs 48% for Tpeak-end). Conclusion Tpeak-end and Tpeak-end/QT ratio are prolonged in patients with STEMI compared with healthy individuals, and Tpeak-end > 0.1 and Tpeak-end/QT ratio > 0.3 predict malignant ventricular arrhythmias within 24 hours of STEMI.

Original languageEnglish
Pages (from-to)484-489
Number of pages6
JournalHeart Rhythm
Volume12
Issue number3
DOIs
Publication statusPublished - 01-01-2015

Fingerprint

Case-Control Studies
Cardiac Arrhythmias
Myocardial Infarction
Patient Admission
Intensive Care Units
Electrocardiography
ST Elevation Myocardial Infarction

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

@article{2f695ec80cb941549ea5073d7b6c572d,
title = "Prolonged Tpeak-end and Tpeak-end/QT ratio as predictors of malignant ventricular arrhythmias in the acute phase of ST-segment elevation myocardial infarction: A prospective case-control study",
abstract = "Background Prolonged Tpeak-end (the interval from the peak of the T wave to the end of the T wave) and Tpeak-end/QT ratio have been shown to be markers of arrhythmogenesis in various cardiac disorders. Objectives The purpose of this study was to evaluate the utility of Tpeak-end and Tpeak-end/QT ratio at admission in patients with acute ST-segment elevation myocardial infarction (STEMI) in predicting malignant ventricular arrhythmias. Methods The study group included 50 patients presenting with STEMI, in whom Tpeak-end and Tpeak-end/QT ratio were measured at admission; these patients were monitored for arrhythmias with a continuous electrocardiogram in the intensive care unit for 48 hours, and 50 healthy individuals acted as controls. Results The Tpeak-end (0.11 ± 0.04 seconds vs 0.08 ± 0.006 seconds; P <.0010) and Tpeak-end/QT ratio (0.30 ± 0.06 vs 0.21 ± 0.02; P <.001) were prolonged in patients with STEMI. Three patients with STEMI who sustained ventricular fibrillation (VF) within 24 hours of admission had prolonged corrected QT interval (0.39 ± 0.04 seconds vs 0.46 ± 0.13 seconds; P =.019), Tpeak-end (0.10 ± 0.02 seconds vs 0.20 ± 0.11 seconds; P <.001), and Tpeak-end/QT ratio (0.26 ± 0.05 vs 0.41 ± 0.09; P <.001) as compared with patients with STEMI without VF. Tpeak-end > 0.1 seconds and Tpeak-end/QT ratio > 0.3 predicted VF with a sensitivity of 100{\%}. However, the Tpeak-end/QT ratio had a higher specificity (82.9{\%} for Tpeak-end/QT ratio vs 44.7{\%} for Tpeak-end) and accuracy (84{\%} for Tpeak-end/QT ratio vs 48{\%} for Tpeak-end). Conclusion Tpeak-end and Tpeak-end/QT ratio are prolonged in patients with STEMI compared with healthy individuals, and Tpeak-end > 0.1 and Tpeak-end/QT ratio > 0.3 predict malignant ventricular arrhythmias within 24 hours of STEMI.",
author = "Jayaprakash Shenthar and Surender Deora and Maneesh Rai and {Nanjappa Manjunath}, Chollenhalli",
year = "2015",
month = "1",
day = "1",
doi = "10.1016/j.hrthm.2014.11.034",
language = "English",
volume = "12",
pages = "484--489",
journal = "Heart Rhythm",
issn = "1547-5271",
publisher = "Elsevier",
number = "3",

}

Prolonged Tpeak-end and Tpeak-end/QT ratio as predictors of malignant ventricular arrhythmias in the acute phase of ST-segment elevation myocardial infarction : A prospective case-control study. / Shenthar, Jayaprakash; Deora, Surender; Rai, Maneesh; Nanjappa Manjunath, Chollenhalli.

In: Heart Rhythm, Vol. 12, No. 3, 01.01.2015, p. 484-489.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prolonged Tpeak-end and Tpeak-end/QT ratio as predictors of malignant ventricular arrhythmias in the acute phase of ST-segment elevation myocardial infarction

T2 - A prospective case-control study

AU - Shenthar, Jayaprakash

AU - Deora, Surender

AU - Rai, Maneesh

AU - Nanjappa Manjunath, Chollenhalli

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background Prolonged Tpeak-end (the interval from the peak of the T wave to the end of the T wave) and Tpeak-end/QT ratio have been shown to be markers of arrhythmogenesis in various cardiac disorders. Objectives The purpose of this study was to evaluate the utility of Tpeak-end and Tpeak-end/QT ratio at admission in patients with acute ST-segment elevation myocardial infarction (STEMI) in predicting malignant ventricular arrhythmias. Methods The study group included 50 patients presenting with STEMI, in whom Tpeak-end and Tpeak-end/QT ratio were measured at admission; these patients were monitored for arrhythmias with a continuous electrocardiogram in the intensive care unit for 48 hours, and 50 healthy individuals acted as controls. Results The Tpeak-end (0.11 ± 0.04 seconds vs 0.08 ± 0.006 seconds; P <.0010) and Tpeak-end/QT ratio (0.30 ± 0.06 vs 0.21 ± 0.02; P <.001) were prolonged in patients with STEMI. Three patients with STEMI who sustained ventricular fibrillation (VF) within 24 hours of admission had prolonged corrected QT interval (0.39 ± 0.04 seconds vs 0.46 ± 0.13 seconds; P =.019), Tpeak-end (0.10 ± 0.02 seconds vs 0.20 ± 0.11 seconds; P <.001), and Tpeak-end/QT ratio (0.26 ± 0.05 vs 0.41 ± 0.09; P <.001) as compared with patients with STEMI without VF. Tpeak-end > 0.1 seconds and Tpeak-end/QT ratio > 0.3 predicted VF with a sensitivity of 100%. However, the Tpeak-end/QT ratio had a higher specificity (82.9% for Tpeak-end/QT ratio vs 44.7% for Tpeak-end) and accuracy (84% for Tpeak-end/QT ratio vs 48% for Tpeak-end). Conclusion Tpeak-end and Tpeak-end/QT ratio are prolonged in patients with STEMI compared with healthy individuals, and Tpeak-end > 0.1 and Tpeak-end/QT ratio > 0.3 predict malignant ventricular arrhythmias within 24 hours of STEMI.

AB - Background Prolonged Tpeak-end (the interval from the peak of the T wave to the end of the T wave) and Tpeak-end/QT ratio have been shown to be markers of arrhythmogenesis in various cardiac disorders. Objectives The purpose of this study was to evaluate the utility of Tpeak-end and Tpeak-end/QT ratio at admission in patients with acute ST-segment elevation myocardial infarction (STEMI) in predicting malignant ventricular arrhythmias. Methods The study group included 50 patients presenting with STEMI, in whom Tpeak-end and Tpeak-end/QT ratio were measured at admission; these patients were monitored for arrhythmias with a continuous electrocardiogram in the intensive care unit for 48 hours, and 50 healthy individuals acted as controls. Results The Tpeak-end (0.11 ± 0.04 seconds vs 0.08 ± 0.006 seconds; P <.0010) and Tpeak-end/QT ratio (0.30 ± 0.06 vs 0.21 ± 0.02; P <.001) were prolonged in patients with STEMI. Three patients with STEMI who sustained ventricular fibrillation (VF) within 24 hours of admission had prolonged corrected QT interval (0.39 ± 0.04 seconds vs 0.46 ± 0.13 seconds; P =.019), Tpeak-end (0.10 ± 0.02 seconds vs 0.20 ± 0.11 seconds; P <.001), and Tpeak-end/QT ratio (0.26 ± 0.05 vs 0.41 ± 0.09; P <.001) as compared with patients with STEMI without VF. Tpeak-end > 0.1 seconds and Tpeak-end/QT ratio > 0.3 predicted VF with a sensitivity of 100%. However, the Tpeak-end/QT ratio had a higher specificity (82.9% for Tpeak-end/QT ratio vs 44.7% for Tpeak-end) and accuracy (84% for Tpeak-end/QT ratio vs 48% for Tpeak-end). Conclusion Tpeak-end and Tpeak-end/QT ratio are prolonged in patients with STEMI compared with healthy individuals, and Tpeak-end > 0.1 and Tpeak-end/QT ratio > 0.3 predict malignant ventricular arrhythmias within 24 hours of STEMI.

UR - http://www.scopus.com/inward/record.url?scp=84924087065&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84924087065&partnerID=8YFLogxK

U2 - 10.1016/j.hrthm.2014.11.034

DO - 10.1016/j.hrthm.2014.11.034

M3 - Article

C2 - 25557980

AN - SCOPUS:84924087065

VL - 12

SP - 484

EP - 489

JO - Heart Rhythm

JF - Heart Rhythm

SN - 1547-5271

IS - 3

ER -