Skip to main content
Clinical Cardiology logoLink to Clinical Cardiology
. 2008 May 12;31(5):205–210. doi: 10.1002/clc.20153

QT Dispersion at Rest and During Adenosine Stress Myocardial Perfusion Imaging Correlation with Myocardial Jeopardy Score

J Pradhan 1,4, H Vankayala 1,3, A Niraj 1,3, P Kumaravelu 1,3, M Trivedi 3, D Thatai 2,3,5,, L Afonso 2
PMCID: PMC6653464  PMID: 18473373

Abstract

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.

Keywords: QT dispersion, Duke Score, adenosine, myocardial perfusion imaging

Full Text

The Full Text of this article is available as a PDF (515.0 KB).

References

  • 1. Fleischmann KE, Hunink MG, Kuntz KM, Douglas PS: Exercise echocardiography or exercise SPECT imaging? A meta‐analysis of diagnostic test performance. JAMA 1998; 280: 913–920. [DOI] [PubMed] [Google Scholar]
  • 2. Guideri F, Ferber D, Galgano G, et al.: QTc interval prolongation during infusion with dipyridamole or adenosine. Int J Cardiol 1995; 48: 67–73. [DOI] [PubMed] [Google Scholar]
  • 3. Schmidt M, Schneider C, Theissen P, Erdmann E, Schicha H: QT dispersion in comparison to Tl‐201‐SPECT for detection of myocardial ischaemia. Int J Cardiol 2006; 113: 327–331. [DOI] [PubMed] [Google Scholar]
  • 4. Teragawa H, Hirao H, Muraoka Y, Yamagata T, Matsuura H, et al.: Relation between QT dispersion and adenosine triphosphate stress thallium‐201 single‐photon emission computed tomographic imaging for detecting myocardial ischemia and scar. Am J Cardiol 1999; 83: 1152–1156. [DOI] [PubMed] [Google Scholar]
  • 5. Cin VG, Celik M, Ulucan S: QT dispersion ratio in patients with unstable angina pectoris (a new risk factor?) Clin Cardiol 1997; 20: 533–535. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 6. Malik M, Batchvarov VN: Measurement, interpretation and clinical potential of QT dispersion. J Am Coll Cardiol 2000; 36: 1749–1766. [DOI] [PubMed] [Google Scholar]
  • 7. Somberg JC, Molnar J: Usefulness of QT dispersion as an electrocardiographically derived index. Am J Cardiol 2002; 89: 291–294. [DOI] [PubMed] [Google Scholar]
  • 8. Yilmaz R, Demirbag R, Gur M: The association of QT dispersion and QT dispersion ratio with extent and severity of coronary artery disease. Ann Noninvasive Electrocardiol 2006; 11: 43–51. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9. Friesinger GCPE, Ross RC: Prognostic significance of coronary arteriography. Trans Assoc Am Physicians 1970; 83: 78–89. [PubMed] [Google Scholar]
  • 10. Gensini G: Coronary Arteriography. New York, NY: Futura; 1975. [Google Scholar]
  • 11. Sullivan DR, Marwick TH, Freedman SB: A new method of scoring coronary angiograms to reflect extent of coronary atherosclerosis and improve correlation with major risk factors. Am Heart J 1990; 119: 1262–1267. [DOI] [PubMed] [Google Scholar]
  • 12. Graham MM, Faris PD, Ghali WA, et al. Validation of three myocardial jeopardy scores in a population‐based cardiac catheterization cohort. Am Heart J 2001; 142: 254–261. [DOI] [PubMed] [Google Scholar]
  • 13. Liu BA, Juurlink DN: Drugs and the QT interval: caveat doctor. N Engl J Med 2004; 351: 1053–1056pp. [DOI] [PubMed] [Google Scholar]
  • 14. Ritchie JL, Bateman TM, Bonow RO, et al.: Guidelines for clinical use of cardiac radionuclide imaging. Report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Committee on Radionuclide Imaging), developed in collaboration with the American Society of Nuclear Cardiology. J Am Coll Cardiol 1995; 25: 521–547. [DOI] [PubMed] [Google Scholar]
  • 15.American Society of Nuclear Cardiology: Updated imaging guidelines for nuclear cardiology procedures, part 1. J Nucl Cardiol 2001; 8: G5–G58. [DOI] [PubMed] [Google Scholar]
  • 16. Hendel RC, Wackers FJ, Berman DS, Ficaro E, Depuey EG, et al.: American Society of Nuclear Cardiology consensus statement reporting of radionuclide myocardial perfusion imaging studies. J Nucl Cardiol 2003; 10: 705–708. [DOI] [PubMed] [Google Scholar]
  • 17. Veglio M, Giunti S, Stevens LK, Fuller JH, Perin PC: Prevalence of Q‐T interval dispersion in type 1 diabetes and its relation with cardiac ischemia: the EURODIAB IDDM Complications Study Group. Diabetes Care 2002; 25: 702–707. [DOI] [PubMed] [Google Scholar]
  • 18. Bazett H: An analysis of time‐relations of electrocardiograms. Hearts 1920; 7: 353–370. [Google Scholar]
  • 19. Califf RM, Phillips HR III, Hindman MC, et al.: Prognostic value of a coronary artery jeopardy score. J Am Coll Cardiol 1985; 5: 1055–1063. [DOI] [PubMed] [Google Scholar]
  • 20. Brandt PW, Partridge JB, Wattie WJ: Coronary arteriography: method of presentation of the arteriogram report and a scoring system. Clin Radiol 1977; 28: 361–365. [DOI] [PubMed] [Google Scholar]
  • 21. Lowe MD, Rowland E, Grace AA: QT dispersion and triple‐vessel coronary disease. Lancet 1997; 349: 1175–1176. [DOI] [PubMed] [Google Scholar]
  • 22. Stoletniy LN, Pai RG: Usefulness of QTc dispersion in interpreting exercise electrocardiograms. Am Heart J 1995; 130: 918–921. [DOI] [PubMed] [Google Scholar]
  • 23. Stoletniy LN, Pai RG: Value of QT dispersion in the interpretation of exercise stress test in women. Circulation 1997; 96: 904–910. [DOI] [PubMed] [Google Scholar]
  • 24. Lyras TG, Papapanagiotou VA, Foukarakis MG, et al.: Evaluation of serial QT dispersion in patients with first non‐Q‐wave myocardial infarction: relation to the severity of underlying coronary artery disease. Clin Cardiol 2003; 26: 189–195. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 25. Sporton SC, Taggart P, Sutton PM, Walker JM, Hardman SM: Acute ischaemia: a dynamic influence on QT dispersion. Lancet 1997; 349: 306–309. [DOI] [PubMed] [Google Scholar]
  • 26. Stierle U, Giannitsis E, Sheikhzadeh A, et al.: Relation between QT dispersion and the extent of myocardial ischemia in patients with three‐vessel coronary artery disease. Am J Cardiol 1998; 81; 564–568. [DOI] [PubMed] [Google Scholar]

Articles from Clinical Cardiology are provided here courtesy of Wiley

RESOURCES