QT Interval Dispersion Behavior in Patients With and Without Obstructive Coronary Artery Disease Undergoing Exercise Test

AbstractIdentification of obstructive coronary artery disease (OCAD) in patients with chest pain is a clinical challenge. The value of corrected QT interval (QTc) for the prediction of OCAD has yet to be established. We consecutively enrolled 1741 patients with suspected angina. The presence of obstructive OCAD was defined as ≥ 50% diameter stenosis by coronary angiography. The pre-test probability was evaluated by combining QTc prolongation with the CAD Consortium clinical score (CAD2) and the updated Diamond-Forrester (UDF) score. OCAD was detected in 661 patients (38.0%). QTc was longer in patients with OCAD compared with those without OCAD (444 ± 34 vs. 429 ± 28 ms, p < 0.001). QTc was increased by the severity of OCAD (P < 0.001). QTc prolongation was associated with OCAD (odds ratio (OR), 2.27; 95% confidence interval (CI), 1.81–2.85). With QTc, the C-statistics increased significantly from 0.68 (95% CI 0.66–0.71) to 0.76 (95% CI 0.74–0.78) in the CAD2 and from 0.64 (95% CI 0.62–0.67) to 0.74 (95% CI 0.72–0.77) in the UDF score, respectively. QT prolongation predicted the presence of OCAD and the QTc improved model performance to predict OCAD compared with CAD2 or UDF scores in patients with suspected angina.

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Faculty Opinions recommendation of Evaluation of the predictive value of coronary artery calcium score for obstructive coronary artery disease in asymptomatic Korean patients with type 2 diabetes mellitus.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725087687.793510525 ◽

2015 ◽

Author(s):

Nathan Wong

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Coronary Artery Disease ◽

Type 2 Diabetes Mellitus ◽

Coronary Artery ◽

Coronary Artery Calcium Score ◽

Obstructive Coronary Artery Disease ◽

Calcium Score ◽

Artery Disease

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Contribution of the peak exercise QT dispersion to the accuracy of an exercise test during the evaluation of coronary artery disease

Acta Cardiologica ◽

10.2143/ac.55.6.2005764 ◽

2000 ◽

Vol 55 (6) ◽

pp. 335-339 ◽

Cited By ~ 3

Author(s):

Mehmet ÜLGEN ◽

Aziz KARADEDE ◽

Sait ALAN ◽

A. Vahip TEMAMOĞULARI ◽

Aziz KARABULUT ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Exercise Test ◽

Qt Dispersion ◽

Peak Exercise ◽

Artery Disease

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Gender Differences in Non-Obstructive Coronary Artery Disease

Current Pharmaceutical Design ◽

10.2174/1381612826666201012163845 ◽

2020 ◽

Vol 26 ◽

Author(s):

Maria Bergami ◽

Marialuisa Scarpone ◽

Edina Cenko ◽

Elisa Varotti ◽

Peter Louis Amaduzzi ◽

...

Keyword(s):

Coronary Artery Disease ◽

Gender Differences ◽

Heart Disease ◽

Coronary Artery ◽

Ischemic Heart Disease ◽

Coronary Arteries ◽

Obstructive Coronary Artery Disease ◽

Ischemic Heart ◽

Current Evidence ◽

Artery Disease

: Subjects affected by ischemic heart disease with non-obstructive coronary arteries constitute a population that has received increasing attention over the past two decades. Since the first studies with coronary angiography, female patients have been reported to have non-obstructive coronary artery disease more frequently than their male counterparts, both in stable and acute clinical settings. Although traditionally considered a relatively infrequent and low-risk form of myocardial ischemia, its impact on clinical practice is undeniable, especially when it comes to infarction, where the prognosis is not as benign as previously assumed. Unfortunately, despite increasing awareness, there are still several questions left unanswered regarding diagnosis, risk stratification and treatment. The purpose of this review is to provide a state of the art and an update on current evidence available on gender differences in clinical characteristics, management and prognosis of ischemic heart disease with non-obstructive coronary arteries, both in the acute and stable clinical setting.

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OCT Findings in MINOCA

Journal of Clinical Medicine ◽

10.3390/jcm10132759 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2759

Author(s):

Krzysztof Bryniarski ◽

Pawel Gasior ◽

Jacek Legutko ◽

Dawid Makowicz ◽

Anna Kedziora ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Imaging Modality ◽

Obstructive Coronary Artery Disease ◽

Coronary Artery Spasm ◽

Morphological Characteristics ◽

Artery Dissection ◽

Plaque Disruption ◽

Artery Disease

Myocardial infarction with non-obstructive coronary artery disease (MINOCA) is a working diagnosis for patients presenting with acute myocardial infarction without obstructive coronary artery disease on coronary angiography. It is a heterogenous entity with a number of possible etiologies that can be determined through the use of appropriate diagnostic algorithms. Common causes of a MINOCA may include plaque disruption, spontaneous coronary artery dissection, coronary artery spasm, and coronary thromboembolism. Optical coherence tomography (OCT) is an intravascular imaging modality which allows the differentiation of coronary tissue morphological characteristics including the identification of thin cap fibroatheroma and the differentiation between plaque rupture or erosion, due to its high resolution. In this narrative review we will discuss the role of OCT in patients presenting with MINOCA. In this group of patients OCT has been shown to reveal abnormal findings in almost half of the cases. Moreover, combining OCT with cardiac magnetic resonance (CMR) was shown to allow the identification of most of the underlying mechanisms of MINOCA. Hence, it is recommended that both OCT and CMR can be used in patients with a working diagnosis of MINOCA. Well-designed prospective studies are needed in order to gain a better understanding of this condition and to provide optimal management while reducing morbidity and mortality in that subset patients.

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