Can the T-peak to T-end interval be a predictor of mortality in patients with ST-elevation myocardial infarction?

Coron Artery Dis. 2014 Aug;25(5):399-404. doi: 10.1097/MCA.0000000000000101.

Abstract

Background: The interval between the peak and the end of the T wave (Tp-e interval) on 12-lead ECG is a measure of transmural dispersion of repolarization and may be related to malignant ventricular arrhythmias. The objective of this study was to investigate whether the Tp-e interval predicts in-hospital and long-term mortality in patients with ST-segment elevation myocardial infarction (STEMI) undergoing a primary percutaneous coronary intervention (pPCI).

Methods: This study included 488 consecutive patients with STEMI treated with pPCI. Electrocardiograms were obtained after pPCI and the Tp-e interval was measured in leads without ST-segment elevation.

Results: There were 46 (9.4%) deaths in the population, with a mean follow-up time of 21.1±10.2 months. The Tp-e interval was associated with not only in-hospital ventricular tachycardia/fibrillation, target vessel revascularization, and death but also long-term target vessel revascularization and death. Furthermore, the Tp-e interval measured using the tail method was found to be a significant predictor of long-term mortality in multivariable Cox analyses [odds ratio 1.018, 95% confidence interval (1.004-1.033)]. Findings were similar in the Tp-e interval and the heart rate-corrected Tp-e interval (cTp-e).

Conclusion: Tp-e and cTp-e measured using the tail method were found to be predictors of both in-hospital and long-term mortality.

MeSH terms

  • Action Potentials
  • Adult
  • Aged
  • Chi-Square Distribution
  • Electrocardiography*
  • Female
  • Heart Conduction System / physiopathology*
  • Hospital Mortality
  • Humans
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / mortality*
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / therapy
  • Odds Ratio
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / mortality
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Risk Factors
  • Tachycardia, Ventricular / etiology
  • Tachycardia, Ventricular / mortality
  • Tachycardia, Ventricular / physiopathology
  • Time Factors
  • Treatment Outcome
  • Ventricular Fibrillation / etiology
  • Ventricular Fibrillation / mortality
  • Ventricular Fibrillation / physiopathology