Prematür Koroner Arter Hastalığında Repolarizasyon Parametreleri
Amaç: Genç bireylerde koroner arter hastalığı nispeten nadir görülür. Literatürde genç yaşta koroner arter hastalığı ile ilgili sınırlı veri mevcuttur. Bu çalışmada yeni tanı almış prematür koroner arter hastalığı olanlarda repolarizasyon parametreleri değerlendirildi. Gereç ve Yöntem: Çalışmaya toplam 200 hasta [128 erkek, 38,0 (29,3-42,0) yaş] dahil edildi ve bunlardan 100’ü yeni tanı prematür koroner arter hastalığı (yaş ≤45) olan çalışma grubunu oluşturdu. Kalan 100 hasta iyi eşleştirilmiş kontrol grubunu oluşturdu. İki grup arasında DII, V2 ve V6 derivasyonlarında ölçülen, QTc intervali, Tp-e intervali ve Tp-e∕QTc den oluşan repolarizasyon parametreleri karşılaştırıldı. Bulgular: Median QTc intervali D2 derivasyonunda (430,3 ms ve 405,3 ms, p
Repolarization Parameters in Patients with Premature Coronary Artery Disease
Objectives: Coronary artery disease (CAD) in young adults is relatively rare. Few data on CAD in young adults are available in the literature. In thecurrent study, repolarization parameters were evaluated in patients with newly diagnosed premature CAD.Materials and Methods: A total of 200 patients [128 male, 38.0 (29.3-42.0) years] were included and 100 cases with newly diagnosed prematurecoronary heart disease (aged ≤45 years) formed the study group. Remaining 100 cases were well-matched controls. Repolarization parametersincluding QTc interval, Tp-e interval and Tp-e∕QTc in leads DII, V2 and V6 were compared between the two groups.Results: The median QTc interval (430.3 ms vs 405.3 ms, p
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- 1. Uhl GS, Farrell PW. Myocardial infarction in young adults: risk factors and
natural history. Am Heart J. 1983;105:548-553.
- 2. Glover MU, Kuber MT, Warren SE, et al. Myocardial infarction before age 36:
risk factor and arteriographic analysis. Am J Cardiol. 1982;49:1600-1603.
- 3. Chouhan L, Hajar HA, Pomposiello JC. Comparison of thrombolytic therapy
for acute myocardial infarction in patients aged < 35 and > 55 years. Am J
Cardiol. 1993;71:157-159.
- 4. Egred M, Viswanathan G, Davis GK. Myocardial infarction in young adults.
Postgrad Med J. 2005;81:741-745.
- 5. van Loon JE, de Maat MP, Deckers JW, et al. Prognostic markers in
young patients with premature coronary heart disease. Atherosclerosis.
2012;224:213-217.
- 6. Konishi H, Miyauchi K, Kasai T, et al. Long-term prognosis and clinical
characteristics of young adults (
- 7. Genest JJ, McNamara JR, Salem DN, et al. Prevalence of risk factors in men
with premature coronary artery disease. Am J Cardiol. 1991;67:1185-1189.
- 8. Christus T, Shukkur AM, Rashdan I, et al. Coronary Artery Disease in Patients
Aged 35 or less - A Different Beast? Heart Views. 2011;12:7-11. PubMed
PMID: 21731802.
- 9. Akosah KO, Schaper A, Cogbill C, et al. Preventing myocardial infarction
in the young adult in the first place: how do the National Cholesterol
Education Panel III guidelines perform? J Am Coll Cardiol. 2003;41:1475-
1479.
- 10. Doughty M, Mehta R, Bruckman D, et al. Acute myocardial infarction in the
young--The University of Michigan experience. Am Heart J. 2002;143:56-62.
- 11. Morillas P, Bertomeu V, Pabon P, et al. Characteristics and outcome of acute
myocardial infarction in young patients. The PRIAMHO II study. Cardiology.
2007;107:217-225.
- 12. Zimmerman FH, Cameron A, Fisher LD, Myocardial infarction in young
adults: angiographic characterization, risk factors and prognosis (Coronary
Artery Surgery Study Registry). J Am Coll Cardiol. 1995;26:654-661.
- 13. Drory Y, Turetz Y, Hiss Y, et al. Sudden unexpected death in persons less than
40 years of age. Am J Cardiol. 1991;68:1388-1392.
- 14. Arzamendi D, Benito B, Tizon-Marcos H, et al. Increase in sudden death from
coronary artery disease in young adults. Am Heart J. 2011;161:574-580.
- 15. Mirvis DM. Spatial variation of QT intervals in normal persons and patients
with acute myocardial infarction. J Am Coll Cardiol. 1985;5:625-631.
- 16. Antzelevitch C, Shimizu W, Yan GX, et al. The M cell: its contribution to
the ECG and to normal and abnormal electrical function of the heart. J
Cardiovasc Electrophysiol. 1999;10:1124-1152.
- 17. Xia Y, Liang Y, Kongstad O, et al. Tpeak-Tend interval as an index of global
dispersion of ventricular repolarization: evaluations using monophasic
action potential mapping of the epi- and endocardium in swine. J Interv
Card Electrophysiol. 2005;14:79-87.
- 18. Gupta P, Patel C, Patel H, et al. T(p-e)/QT ratio as an index of arrhythmogenesis.
J Electrocardiol. 2008;41:567-574.
- 19. Zhao X, Xie Z, Chu Y, et al. Association between Tp-e/QT ratio and prognosis
in patients undergoing primary percutaneous coronary intervention for STsegment
elevation myocardial infarction. Clin Cardiol. 2012;35:559-564.
- 20. Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke
statistics--2012 update: a report from the American Heart Association.
Circulation. 2012;125:e2-e220. PubMed PMID: 22179539.
- 21. Chan MY, Woo KS, Wong HB, Chia BL, et al. Antecedent risk factors and
their control in young patients with a first myocardial infarction. Singapore
Med J. 2006;47:27-30.
- 22. Chen L, Chester M, Kaski JC. Clinical factors and angiographic features
associated with premature coronary artery disease. Chest. 1995;108:364-
369.
- 23. Klein LW, Agarwal JB, Herlich MB, et al. Prognosis of symptomatic
coronary artery disease in young adults aged 40 years or less. Am J Cardiol.
1987;60:1269-1272.
- 24. Cole JH, Miller JI, 3rd, Sperling LS, et al. Long-term follow-up of coronary
artery disease presenting in young adults. J Am Coll Cardiol. 2003;41:521-
528.
- 25. Goldberg RJ, McCormick D, Gurwitz JH, et al. Age-related trends in shortand
long-term survival after acute myocardial infarction: a 20-year
population-based perspective (1975-1995). Am J Cardiol. 1998;82:1311-
1317.
- 26. Holmes DR, Jr., White HD, Pieper KS, et al. Effect of age on outcome with
primary angioplasty versus thrombolysis. J Am Coll Cardiol. 1999;33:412-
419.
- 27. Kors JA, Ritsema van Eck HJ, van Herpen G. The meaning of the Tp-Te
interval and its diagnostic value. J Electrocardiol. 2008;41:575-580.
- 28. Hetland M, Haugaa KH, Sarvari SI, et al. A novel ECG-index for prediction
of ventricular arrhythmias in patients after myocardial infarction. Ann
Noninvasive Electrocardiol. 2014;19:330-337.
- 29. Mulay DV, Quadri SM. QT dispersion and early arrhythmic risk in acute
myocardial infarction. Indian Heart J. 2004;56:636-641.
- 30. O’Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for
the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association
Task Force on Practice Guidelines. Circulation. 2013;127:e362-425.
- 31. Schwartz PJ, Wolf S. QT interval prolongation as predictor of sudden death
in patients with myocardial infarction. Circulation. 1978;57:1074-1077.
- 32. Xianpei W, Sha W, Chuanyu G, et al. Tpeak-Tend dispersion as a predictor
for malignant arrhythmia events in patients with vasospastic angina. Int J
Cardiol. 2017;249:61-65.
- 33. Sucu M, Ucaman B, Ozer O, et al. Novel Ventricular Repolarization Indices in
Patients with Coronary Slow Flow. J Atr Fibrillation. 2016;9:1446. PubMed
PMID: 28496926.
- 34. Karakaya O, Saglam M, Barutcu I, Kargin R, et al. Effects of isolated coronary
artery ectasia on electrocardiographic parameters reflecting ventricular
heterogeneity. J Electrocardiol. 2007;40:203-206.
- 35. Mahmoud K. Effect of isolated coronary artery ectasia on dispersion of
P-wave and QT interval. The Egyptian Heart Journal. 2012;64:121-125.
- 36. Tasolar H, Balli M, Cetin M, et al. Effects of the coronary collateral
circulation on the Tp-e interval and Tp-e/QT ratio in patients with stable
coronary artery disease. Ann Noninvasive Electrocardiol. 2015;20:53-61.
- 37. Haarmark C, Hansen PR, Vedel-Larsen E, et al.The prognostic value of
the Tpeak-Tend interval in patients undergoing primary percutaneous
coronary intervention for ST-segment elevation myocardial infarction. J
Electrocardiol. 2009;42:555-560.
- 38. Davies MJ. Pathological view of sudden cardiac death. Br Heart J.
1981;45:88-96. PubMed PMID: 6450599.
- 39. Acar G, Yorgun H, Inci MF, et al. Evaluation of Tp-e interval and Tp-e/QT
ratio in patients with ankylosing spondylitis. Mod Rheumatol. 2013.
- 40. Mozos I. The link between ventricular repolarization variables and arterial
function. J Electrocardiol. 2015;48:145-149.