Open AccessQT Dispersion at Rest and During Adenosine Stress Myocardial Perfusion Imaging Correlation with Myocardial Jeopardy Score
Author(s) -
Pradhan J.,
Vankayala H.,
Niraj A.,
Kumaravelu P.,
Trivedi M.,
Thatai D.,
Afonso L.
Publication year - 2008
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20153
Subject(s) - medicine , cardiology , coronary artery disease , quartile , myocardial perfusion imaging , odds ratio , confidence interval
Background The usefulness of QT dispersion (QTd) during adenosine myocardial perfusion imaging (MPI) to predict severity of coronary artery disease (CAD) has not been studied. Methods Eighty‐eight patients referred for diagnostic cardiac catheterization after abnormal MPI were included. Thirty‐four patients with no stenosis (Duke Score = 0) were included in Group 1, and 54 patients with significant CAD (Duke Score ≥ 2) formed Group 2. Resting and stress QTd and prolongation in QTd (ΔQTd) were measured and evaluated as independent predictors for severity of CAD. Results Resting QTd was higher in Group 2 as compared with Group 1. During peak infusion of adenosine, QTd was significantly prolonged in Group 1 but remained unchanged, or fixed, in Group 2. In addition, in patients with significant CAD, resting QTd positively correlated with the Duke Score. On multiple regression analysis; independent predictors for significant CAD (odds ratio [OR], 95% confidence interval [CI], p‐value) were resting QTd (4.9, 95% CI 1.1–21.6, < 0.05 for fourth Quartile compared with first Quartile) and ΔQTd (4.0, 1.4–11.2, < 0.01 for first and second Quartiles compared with third and fourth Quartiles). Conclusion In patients with abnormal stress MPI, prolonged resting QTd, and fixation of QTd during stress are independent predictors of significant CAD. In addition, resting QTd correlate with the Duke Jeopardy Score and therefore, may have independent prognostic value. Copyright © 2008 Wiley Periodicals, Inc.