Holter monitoring in patients with stable cad: new opportunities
- Authors: Fedulaev Y.N.1, Makarova I.V.1, Pinchuk T.V.1, Andreeva O.N.1
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Affiliations:
- Pirogov Russian National Research Medical University
- Issue: Vol 23, No 6 (2021)
- Pages: 518-521
- Section: Articles
- URL: https://journals.rcsi.science/2075-1753/article/view/95504
- DOI: https://doi.org/10.26442/20751753.2021.6.200498
- ID: 95504
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Abstract
Background. Noninvasive diagnosis of coronary artery disease (CAD) represents a real problem in clinical practice and can be improved by use of novel additional Holter ECG options. Aim. To evaluate the markers of electrical inhomogeneity of repolarization process in patients with various degree of coronary atherosclerosis. Materials and methods. All 116 patients, hospitalized for diagnostic coronary angiography, were divided into three groups: 1 - severe coronary atherosclerosis, 2 - initial atherosclerosis, 3 - normal coronary arteries (control group). A 12-lead Holter electrocardiography was performed to evaluate microvolt T-wave alternans (MTWA), QT and QTc dispersion on maximal and minimal heart rate (QTdmax and QTcdmax, QTdmin and QTcdmin respectively). Results. Results of a comparative analysis have demonstrated significant differences between three mentioned groups referring to MTWA (р=0,015). QTdmax (р1-2<0.001, р1-3=0.002) as well as QTcdmax (р1-2<0.0001, р1-3=0.001) were significantly higher in group 1 compared to others. At the same time, QTdmin and QTcdmin values didn't differ between the groups. The results of a current study indicated increased absolute values of the markers of an impaired repolarization in individuals with severe coronary atherosclerosis (compared to initial atherosclerosis and normal coronary arteries). Conclusion. The markers of electrical inhomogeneity of repolarization process in the myocardium (MTWA, QTdmax and QTcdmax) represent perspective ECG instruments in evaluation of the severity of coronary atherosclerosis in patients with stable CAD, still requesting futher investigation.
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##article.viewOnOriginalSite##About the authors
Yuri N. Fedulaev
Pirogov Russian National Research Medical Universityд-р мед. наук, проф., зав. каф. Moscow, Russia
Irina V. Makarova
Pirogov Russian National Research Medical University
Email: irina-makarova93@mail.ru
ассистент каф. Moscow, Russia
Tatiana V. Pinchuk
Pirogov Russian National Research Medical University
Email: doktor2000@inbox.ru
канд. мед. наук, доц. каф. Moscow, Russia
Olga N. Andreeva
Pirogov Russian National Research Medical Universityканд. мед. наук, доц. каф. Moscow, Russia
References
- Brugada J, Katritsis DG, Arbelo E, et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardia. Eur Heart J. 20201;41(5):655-720.
- Национальные российские рекомендации по применению методики холтеровского мониторирования в клинической практике. Рос. кардиол.журн. 2014;2(106):6-71
- Knuuti J, Wijns W, Saraste A, et al. 2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;3(41):407-77.
- Bjerregaard P, El-Shafei A, Kotar SL, Labovitz AJ. ST segment analysis by Holter Monitoring: methodological considerations. Ann Noninvasive Electrocardiol. 2003;8(3):200-7.
- Tzivoni D. Value and limitations of ambulatory ECG monitoring for assessment of myocardial ischemia. Ann Noninvasive Electrocardiol. 2001;6(3):236-42.
- Nurkalem Z, Hasdemir H, Ergelen M, et al. The relationship between glucose tolerance and severity of coronary artery disease using the gensini score. Angiology. 2010;61(8):751-55.
- Huebner T, Goernig M, Schuepbach M, et al. Electrocardiologic and related methods of non-invasive detection and risk stratification in myocardial ischemia: state of the art and perspectives. Ger Med Sci. 2010;8:Doc27. D0I:10.3205/000116
- Окишева Е.А., Царегородцев Д.А., Сулимов В.А. Возможности холтеровского мониторирования в оценке микровольтной альтернации зубца Т и турбулентности ритма сердца у больных, перенесших инфаркт миокарда. Ультразвуковая и функциональная диагностика. 2011;3:59-70
- Nieminen T, Lehtimaki T, Viik J, et al. T-wave alternans predicts mortality in a population undergoing a clinically indicated exercise test. Eur Heart J. 2007;28(19):2332-7.
- Demirta? AO, Urgun OD. Can QTinterval prolongation or dispersion detected in a positive exercise ECG test predict critical coronary artery disease? Arch MedSci Atheroscler Dis. 2019;1(4):7-12.
- Hasan-Ali H, Maghraby MH, Fouad A, Abdel-Sayed A. Corrected QTdispersion improves diagnostic performance of exercise testing in diagnosing coronary artery disease. East Mediterr Health J. 2010;16(1):75-81.
- Helmy H, Abdel-Galeel A, Taha Kishk Y, Mohammed Sleem K. Correlation of corrected QTdispersion with the severity of coronary artery disease detected by SYNTAX score in non-diabetic patients with STEMI. Egypt Heart J. 2017;2(69):111-7.