Dynamic changes in electrocardiographic findings between initial and follow-up electrocardiography: The role of the T/QRS ratio - 16/03/22
Abstract |
Background |
Dynamic changes in electrocardiographic findings between initial and follow-up electrocardiograms (ECGs) have rarely been studied for disease severity and differential diagnosis in non-ST elevation acute coronary syndrome. We aimed to determine whether the changes in staple variables on ECG can assist in distinguishing between neuropsychiatric or gastrointestinal disorders (mild non-ischemic disorders), heart failure, and NSTE-ACS (non-ST elevation acute coronary syndrome).
Methods |
This retrospective study enrolled 1279 patients who presented with ischemic symptoms; were diagnosed with NSTE-ACS, acute heart failure, and mild disorders; and underwent echocardiography and coronary angiography. After performing propensity matching of the ECG follow-up interval, 184 patients with symptom onset within 48 h were included and analyzed.
Results |
As a discriminator for NSTE-ACS, the maximum change in the T/QRS ratio in two contiguous leads was superior to the maximum change in ST segment depression, T wave inversion, and ST/T ratio. ECGs of patients with NSTE-ACS and heart failure showed a tendency to increase and decrease the T/QRS ratio change, respectively. Compared with regional wall motion abnormality, the change in troponin I/h and the maximum change in ST segment depression and T-wave inversion, the most deviated T/QRS ratio change from 1 (>1.5 or < 0.5) in two contiguous leads was the most significant discriminator for disease severity and differential diagnosis (standardized β = 0.545, p < 0.001).
Conclusion |
The maximum changes in the T/QRS ratio in two contiguous leads can assist in distinguishing disease severity and acute mimicking disease such as acute heart failure in patients with suspected ACS.
Le texte complet de cet article est disponible en PDF.Keywords : Electrocardiography, Acute coronary syndrome, Acute heart failure, Coronary angiography
Plan
Vol 54
P. 8-14 - avril 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?