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2017 ; 96
(43
): e8430
Nephropedia Template TP
gab.com Text
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English Wikipedia
Diagnostic value of the corrected QT difference between leads V1 and V6 in
patients with acute pulmonary thromboembolism
#MMPMID29069044
Park SJ
; Kwon CH
; Bae BJ
; Kim BS
; Kim SH
; Kim HJ
; Hwang HK
; Chung SM
Medicine (Baltimore)
2017[Oct]; 96
(43
): e8430
PMID29069044
show ga
In acute pulmonary thromboembolism (PTE), right ventricular pressure overload
impairs right-sided cardiac conduction and repolarization. We hypothesized that
if heterogeneity of repolarization between right and left ventricles occurs in
acute PTE, there would be the difference of repolarization between them.
Therefore, we aimed to evaluate the diagnostic value of corrected QT interval
(QTc) difference between leads V1 and V6 (V1?-?V6) in patients with acute PTE.A
total of 89 patients with suspected acute PTE who underwent computed tomographic
angiography (CTA) were enrolled from January to December 2015. PTE was identified
by CTA. We compared electrocardiographic (ECG) parameters, especially QTc
difference (V1?-?V6) between patients with PTE and those without PTE.Acute PTE
was finally diagnosed in 45 patients. Clinical situations including the chief
complaint were not different between PTE and non-PTE groups. S1Q3T3, a
traditional ECG marker, had no diagnostic value for acute PTE. Patients with PTE
had a significantly longer mean QTc in V1 (454.6?±?44.3 vs 417.5?±?31.3?ms,
P?.001) and larger QTc difference (V1?-?V6) (34.8?±?30.5 vs -12.5?±?16.6?ms,
P?.001) than non-PTE controls. QTc difference (V1?-?V6) was negative in all
patients without PTE. PTE patients had a higher prevalence of T wave inversion in
leads III (51.1% vs 29.5%, P?=?.038) and V1 (82.2% vs 38.6%, P?.001). A QTc
difference (V1?-?V6) of ?20?ms identified PTE with 82.2% sensitivity, 100.0%
specificity, and 100.0% positive predictive value.QTc difference (V1?-?V6) had an
excellent diagnostic value for differentiating patients with and without acute
PTE.