Myocardial perfusion defect assessed by single-photon emission computed tomography and frontal QRS-T angle in patients with prior anterior myocardial infarction
- 15 Downloads
The frontal QRS-T angle is one of the markers of ventricular repolarization. We sought to assess the effects of myocardial perfusion defect on QRS-T angle in patients with prior anterior myocardial infarction (MI). Seventy-one patients with prior anterior MI and 71 age- and sex-matched control subjects having no myocardial perfusion defect were selected. Frontal QRS-T angle was defined as the absolute value of the difference between the frontal plane QRS axis and T-wave axis. The extent of myocardial perfusion defect was determined using myocardial perfusion single-photon emission computed tomography (SPECT). The extent of myocardial perfusion defect of patients with prior anterior MI was 21.8 ± 13.7%. Frontal QRS-T angle was significantly larger in patients with prior anterior MI than control subjects (82° ± 49° vs 30° ± 26°, p < 0.001). Prevalence of abnormal frontal QRS-T angle defined as more than 90° was significantly higher in patients with prior anterior MI than control subjects (42% vs 4%, p < 0.001). Multivariate linear regression analysis showed that age (β=0.18, p = 0.02) and myocardial perfusion defect (β = 0.46, p = 0.02) were independent determinants of frontal QRS-T angle. Our results suggest that the extent of myocardial perfusion defect is an independent determinant of frontal QRS-T angle in patients with prior anterior MI.
KeywordsElectrocardiogram Myocardial infarction Ventricular repolarization
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 5.Lown MT, Munyombwe T, Harrison W, West RM, Hall CA, Morrell C, Jackson BM, Sapsford RJ, Kilcullen N, Pepper CB, Batin PD, Hall AS, Gale CP, Evaluation of Methods and Management of Acute Coronary Events (EMMACE) Investigators (2012) Association of frontal QRS-T angle-age risk score on admission electrocardiogram with mortality in patients admitted with an acute coronary syndrome. Am J Cardiol 109:307–313CrossRefGoogle Scholar
- 7.Kurisu S, Shimonaga T, Ikenaga H, Watanabe N, Higaki T, Ishibashi K, Dohi Y, Fukuda Y, Kihara Y (2017) Selvester QRS score and total perfusion deficit calculated by quantitative gated single-photon emission computed tomography in patients with prior anterior myocardial infarction in the coronary intervention era. Heart Vessels 32:369–375CrossRefGoogle Scholar
- 8.Kurisu S, Nitta K, Sumimoto Y, Ikenaga H, Ishibashi K, Fukuda Y, Kihara Y (2018) Effects of aortic tortuosity on left ventricular diastolic parameters derived from gated myocardial perfusion single photon emission computed tomography in patients with normal myocardial perfusion. Heart Vessels 33:651–656CrossRefGoogle Scholar
- 9.Pavri BB, Hillis MB, Subacius H, Brumberg GE, Schaechter A, Levine JH, Kadish A, Defibrillators in Nonischemic Cardiomyopathy Treatment Evaluation (DEFINITE) Investigators (2008) Prognostic value and temporal behavior of the planar QRS-T angle in patients with nonischemic cardiomyopathy. Circulation 117:3181–3186CrossRefGoogle Scholar
- 10.Padala SK, Ghatak A, Padala S, Katten DM, Polk DM, Heller GV (2014) Cardiovascular risk stratification in diabetic patients following stress single-photon emission-computed tomography myocardial perfusion imaging: the impact of achieved exercise level. J Nucl Cardiol 21:1132–1143CrossRefGoogle Scholar
- 11.Kasama S, Toyama T, Sato M, Sano H, Ueda T, Sasaki T, Nakahara T, Higuchi T, Tsushima Y, Kurabayashi M (2016) Prognostic value of myocardial perfusion single photon emission computed tomography for major adverse cardiac cerebrovascular and renal events in patients with chronic kidney disease: results from first year of follow-up of the Gunma-CKD SPECT multicenter study. Eur J Nucl Med Mol Imaging 43:302–311CrossRefGoogle Scholar
- 13.Zeidan-Shwiri T, Yang Y, Lashevsky I, Kadmon E, Kagal D, Dick A, Laish Farkash A, Paul G, Gao D, Shurrab M, Newman D, Wright G, Crystal E (2015) Magnetic resonance estimates of the extent and heterogeneity of scar tissue in ICD patients with ischemic cardiomyopathy predict ventricular arrhythmia. Heart Rhythm 12:802–808CrossRefGoogle Scholar