Rediscovering Clinical Utility of QT Dispersion: A Long-Forgotten Parameter

Denny Suwanto 1 2 * , Ivana Purnama Dewi 1 2 3 * , Budi Baktijasa Dharmadjati 1 2
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1 Faculty of Medicine, Airlangga University, Surabaya, Indonesia
2 Cardiology and Vascular Medicine Department, Dr. Soetomo General Hospital, Surabaya, Indonesia
3 Faculty of Medicine, Duta Wacana Christian University, Yogyakarta, Indonesia
* Corresponding Author
J CLIN MED KAZ, In press.
OPEN ACCESS

ABSTRACT

Clinical and experimental electrophysiological studies have shown the importance of inhomogeneous myocardial repolarization in ventricular arrhythmias' genesis. Increased dispersion of repolarisation provides a substrate for ventricular arrhythmias by generating functional unidirectional block areas, thereby predisposing to reentry. QT dispersion, defined as the difference between the longest and the shortest QT interval on the surface ECG, is a validated measure of repolarisation dispersion. QT dispersion predicts sudden death and ventricular arrhythmias in patients with chronic heart failure from coronary heart disease and various cardiac diseases

CITATION

Suwanto D, Dewi IP, Dharmadjati BB. Rediscovering Clinical Utility of QT Dispersion: A Long-Forgotten Parameter. J Clin Med Kaz. 2021.

REFERENCES

  • Tokatli A, Yiginer O, Haholu A, Uzun M. Efficiency of quantification of cardiac electrical heterogeneity: Via QT dispersion, transmural dispersion, or both. Biology of Sport. 2015; 32(2):175-6. doi: 10.5604/20831862.1145079.
  • Malik M, Batchvarov VN. Measurement, interpretation, and clinical potential of QT dispersion. Journal of the American College of Cardiology. 2000; 36(6):1749-66. doi: 10.1016/s0735-1097(00)00962-1.
  • Vázquez-Seisdedos CR, Neto JE, Marañón Reyes EJ, Klautau A, Limão de Oliveira RC. New approach for T-wave end detection on electrocardiogram: Performance in noisy conditions. Biomed Eng Online. 2011; 77. doi: 10.1186/1475-925X-10-77.
  • Erikssen G, Liestøl K, Gullestad L, Haugaa KH, Bendz B, Amlie JP. The Terminal Part of the QT Interval (T peak to T end): A Predictor of Mortality after Acute Myocardial Infarction. Ann Noninvasive Electrocardiol. 2012; 17(2):85–94. doi: 10.1111/j.1542-474X.2012.00493.x.
  • Helmy H, Abdel-Galeel A, Taha Kishk Y, Mohammed Sleem K. Correlation of corrected QT dispersion with the severity of coronary artery disease detected by SYNTAX score in non-diabetic patients with STEMI. Egypt Hear J. 2017; 69(2):111-117. doi: 10.1016/j.ehj.2016.12.001.
  • Alabd MA, El-Hammady W, Shawky A, Nammas W, El-Tayeb M. QT Interval and QT Dispersion in Patients Undergoing Hemodialysis: Revisiting the Old Theory. Nephron Extra. 2011; 1.
  • Wu VC, Lin LY, Wu KD. QT interval dispersion in dialysis patients. Nephrology. 2005; 10(2):109-112. doi: 10.1111/j.1440-1797.2005.00391.x.
  • Okin PM, Devereux RB, Howard B V., Fabsitz RR, Lee ET, Welty TK. Assessment of QT interval and QT dispersion for prediction of all-cause and cardiovascular mortality in American Indians: The strong heart study. Circulation. 2000; 101(1):61-66. doi: 10.1161/01.cir.101.1.61.
  • Rodríguez-Jiménez AE, Cruz-Inerarity H, Negrín-Valdés T, Fardales-Rodríguez R, Chávez-González E. Corrected QT-interval dispersion: An electrocardiographic tool to predict recurrence of myocardial infarction. MEDICC Rev. 2019; 21(2-3):22-25.
  • Ale OK, Ajuluchukwu JNA, Oke DA, Mbakwem AC. QT dispersion in hypertensive Nigerians with and without left ventricular hypertrophy. West Afr J Med. 2013; 32(1):57-61.
  • Demirtaş AO, Urgun OD. Can QT interval prolongation or dispersion detected in a positive exercise ECG test predict critical coronary artery disease? Arch Med Sci - Atheroscler Dis. 2019; 4:e7-e12. doi: 10.5114/amsad.2019.83299.
  • Eslami V, Safi M, Taherkhani M, Adibi A, Movahed MR. Evaluation of QT, QT dispersion, and T-wave peak to end time changes after primary percutaneous coronary intervention in patients presenting with acute ST-elevation myocardial infarction. J Invasive Cardiol. 2013; 25(5):232-234.
  • Dotta G, Fonseca FAH, de Oliveira Izar MC, de Souza MT, Moreira FT, Pinheiro LFM, et al. Regional QT interval dispersion as an early predictor of reperfusion in patients with acute myocardial infarction after fibrinolytic therapy. Arq Bras Cardiol. 2019; 112(1): 20-29. doi: 10.5935/abc.20180239.
  • Alici G, Sahin M, Ozkan B, Acar G, Acar RD, Yazicioglu MV, et al. The comparison in reduction of QT dispersion after primary percutaneous coronary intervention according to existence of thrombectomy in ST-segment elevation myocardial infarction. Clin Cardiol. 2013; 36(5):276-9. doi: 10.1002/clc.22109.
  • Alasti M, Adel MH, Torfi E, Noorizadeh M, Bahadoram S, Moghaddam MA, et al. QT dispersion: Does it change after percutaneous coronary intervention? J Tehran Univ Hear Cent. 2011;6(1):19-23.
  • Matsuno Y, Minatoguchi S, Fujiwara H. Effects of candesartan versus amlodipine on home-measured blood pressure, QT dispersion and left ventricular hypertrophy in high-risk hypertensive patients. Blood Press. 2011; 1:12-9. doi: 10.3109/08037051.2010.532339.
  • Ersoy A, Ersoy C, Guler M, Yildiz A. Losartan and QT Dispersion in Hypertensive Patients on Maintenance Hemodialysis. Med Sci | Int Med J. 2014; 3(4):1627-38.
  • Oflaz MB, Balli S, Kibar AE, Ece I, Akdeniz C, Tuzcu V. Effects of carvedilol therapy on cardiac autonomic control, QT dispersion, and ventricular arrhythmias in children with dilated cardiomyopathy. Med Sci Monit. 2013; 19:366-72. doi: 10.12659/MSM.883911.
  • Roden DM. Drug-Induced Prolongation of the QT Interval. N Engl J Med. 2004; 350(10):1013-22. doi: 10.1056/NEJMra032426.
  • Ogiso M, Suzuki A, Shiga T, Nakai K, Shoda M, Hagiwara N. Effect of intravenous amiodarone on QT and T peak-T end dispersions in patients with nonischemic heart failure treated with cardiac resynchronization-defibrillator therapy and electrical storm. J Arrhythmia. 2015; 31(1):1-5. doi: 10.1016/j.joa.2014.01.006.
  • Friedman A, Miles J, Liebelt J, Christia P, Engstrom K, Thachil R, et al. QT Dispersion and Drug-Induced Torsade de Pointes. Cureus. 2021; 13(1):1–10. doi: 10.7759/cureus.12895.
  • Nachimuthu S, Assar MD, Schussler JM. Drug-induced QT interval prolongation: Mechanisms and clinical management. Therapeutic Advances in Drug Safety. 2012. 3(5): 241-253. doi: 10.1177/2042098612454283.
  • Prenner SB, Shah SJ, Goldberger JJ, Sauer AJ. Repolarization Heterogeneity: Beyond the QT Interval. Journal of the American Heart Association. 2016; 5:e003607. doi: 10.1161/JAHA.116.003607