Journal of Electrocardiology
Volume 42, Issue 6 , Pages 555-560 , November 2009

The prognostic value of the Tpeak-Tend interval in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction

  • Christian Haarmark, MD

      Affiliations

    • Laboratory of Experimental Cardiology, University of Copenhagen, Copenhagen, Denmark
    • Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark
    • ,
  • Peter R. Hansen, MD, PhD

      Affiliations

    • Department of Cardiology P, Gentofte University Hospital, Hellerup, Denmark
    • ,
  • Esben Vedel-Larsen, MScEng

      Affiliations

    • Laboratory of Experimental Cardiology, University of Copenhagen, Copenhagen, Denmark
    • Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark
    • ,
  • Sune Haahr Pedersen, MD

      Affiliations

    • Department of Cardiology P, Gentofte University Hospital, Hellerup, Denmark
    • ,
  • Claus Graff, MScEng

      Affiliations

    • Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
    • ,
  • Mads P. Andersen, MScEng

      Affiliations

    • Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
    • ,
  • Egon Toft, MD, PhD

      Affiliations

    • Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
    • ,
  • Fan Wang, MD

      Affiliations

    • Laboratory of Experimental Cardiology, University of Copenhagen, Copenhagen, Denmark
    • Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark
    • ,
  • Johannes J. Struijk, MScEng, PhD

      Affiliations

    • Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
    • ,
  • Jørgen K. Kanters, MD

      Affiliations

    • Laboratory of Experimental Cardiology, University of Copenhagen, Copenhagen, Denmark
    • Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark
    • Department of Cardiology P, Gentofte University Hospital, Hellerup, Denmark
    • Corresponding Author InformationCorresponding author. Laboratory of Experimental Cardiology, University of Copenhagen, Blegdamsvej 3C, DK-2200 Copenhagen N, Denmark.

Received 26 April 2009

References 

  1. Exner DV, Kavanagh KM, Slawnych MP, et al. Noninvasive risk assessment early after a myocardial infarction: The REFINE Study. J Am Coll Cardiol. 2007;50:2275
  2. Lellouche N, De Diego C, Akopyan G, et al. Changes and predictive value of dispersion of repolarization parameters for appropriate therapy in patients with biventricular implantable cardioverter-defibrillators. Heart Rhythm. 2007;4:1274
  3. Kuriachan V, Exner DV. Role of risk stratification after myocardial infarction. Curr Treat Options Cardiovasc Med. 2009;11:10
  4. Cannon CP, Greenberg BH. Risk stratification and prognostic factors in the post-myocardial infarction patient. Am J Cardiol. 2008;102:13G
  5. Huikuri HV, Raatikainen MJP, Moerch-Joergensen R, et al. for the Cardiac A, Risk Stratification After Acute Myocardial Infarction Study Prediction of fatal or near-fatal cardiac arrhythmia events in patients with depressed left ventricular function after an acute myocardial infarction. Eur Heart J. 2009;30:689
  6. Taggart P, Sutton PMI, Opthof T, et al. Transmural repolarisation in the left ventricle in humans during normoxia and ischaemia. Cardiovasc Res. 2001;50:454
  7. Opthof T, Coronel R, Janse MJ. Is there a significant transmural gradient in repolarization time in the intact heart? Repolarization gradients in the intact heart. Circ Arrhythmia Electrophysiol. 2009;2:89
  8. Antzelevitch C. Tpeak-Tend interval as an index of transmural dispersion of repolarization. Eur J Clin Invest. 2001;31:555
  9. Savelieva I, Yap YG, Yi G, Guo X, Camm AJ, Malik M. Comparative reproducibility of QT, QT peak, and T peak-T end intervals and dispersion in normal subjects, patients with myocardial infarction, and patients with hypertrophic cardiomyopathy. Pacing Clin Electrophysiol. 1998;21:2376
  10. Watanabe N, Kobayashi Y, Tanno K, et al. Transmural dispersion of repolarization and ventricular tachyarrhythmias. J Electrocardiol. 2004;37:191
  11. Lubinski A, Kornacewicz-Jach Z, Wnuk-Wojnar AM, et al. The terminal portion of the T wave: a new electrocardiographic marker of risk of ventricular arrhythmias. Pacing Clin Electrophysiol. 2000;23:1957
  12. Yan GX, Antzelevitch C. Cellular basis for the normal T Wave and the electrocardiographic manifestations of the long-QT syndrome. Circulation. 1998;98:1928
  13. Castro Hevia J, Antzelevitch C, Tornes Barzaga F, et al. Tpeak-Tend and Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the brugada syndrome. J Am Coll Cardiol. 2006;47:1828
  14. Haarmark C, Graff C, Andersen MP, et al. Reference values of ECG repolarization variables in a healthy population. J Electrocardiol. 2009;[in review]
  15. Hnatkova K, Gang YI, Batchvarov VN, Malik M. Precision of QT interval measurement by advanced electrocardiographic equipment. Pacing Clin Electrophysiol. 2006;29:1277
  16. Ruopp MD, Perkins NJ, Whitcomb BW, Schisterman EF. Youden index and optimal cut-point estimated from observations affected by a lower limit of detection. Biom J. 2008;50:419
  17. Rubart M, Zipes DP. Mechanisms of sudden cardiac death. J Clin Invest. 2005;115:2305
  18. Burton FL, Cobbe SM. Dispersion of ventricular repolarization and refractory period. Cardiovasc Res. 2001;50:10
  19. Akar JG, Akar FG. Regulation of ion channels and arrhythmias in the ischemic heart. J Electrocardiol. 2007;40:S37
  20. Carmeliet E. Cardiac ionic currents and acute ischemia: from channels to arrhythmias. Physiol Rev. 1999;79:917
  21. Wolk R, Cobbe SM, Hicks MN, Kane KA. Functional, structural, and dynamic basis of electrical heterogeneity in healthy and diseased cardiac muscle: implications for arrhythmogenesis and anti-arrhythmic drug therapy. Pharmacol Ther. 1999;84:207
  22. Coronel R, Wilms-Schopman FJ, Opthof T, Cinca J, Fiolet JW, Janse MJ. Reperfusion arrhythmias in isolated perfused pig hearts. Inhomogeneities in extracellular potassium, ST and TQ potentials, and transmembrane action potentials. Circ Res. 1992;71:1131
  23. Kenigsberg DN, Khanal S, Kowalski M, Krishnan SC. Prolongation of the QTc interval is seen uniformly during early transmural ischemia. J Am Coll Cardiol. 2007;49:1299
  24. Bonnemeier H, Hartmann F, Wiegand UKH, Bode F, Katus HA, Richardt G. Course and prognostic implications of QT interval and QT interval variability after primary coronary angioplasty in acute myocardial infarction. J Am Coll Cardiol. 2001;37:440
  25. Kors JA, van Herpen G, van Bemmel JH. QT dispersion as an attribute of T-loop morphology. Circulation. 1999;99:1458
  26. O'Donnell J, Knoebel SB, Lovelace DE, McHenry PL. Computer quantitation of Q-T and terminal T wave (aT-eT) intervals during exercise: methodology and results in normal men. Am J Cardiol. 1981;47:1168
  27. Bidoggia HC, Maciel JP, Capalozza N, et al. Sex-dependent electrocardiographic pattern of cardiac repolarization. Am Heart J. 2000;140:430
  28. Zabel M, Klingenheben T, Franz MR, Hohnloser SH. Assessment of QT dispersion for prediction of mortality or arrhythmic events after myocardial infarction: results of a prospective, long-term follow-up study. Circulation. 1998;97:2543
  29. Yamaguchi MF, Shimizu MF, Ino HF, et al. T wave peak-to-end interval and QT dispersion in acquired long QT syndrome: a new index for arrhythmogenicity. Clin Sci (Lond). 2003;105:671
  30. Couderc JP, Kaab S, Hinterseer M, et al. Baseline values and sotalol-induced changes of ventricular repolarization duration, heterogeneity, and instability in patients with a history of drug-induced Torsades de Pointes. J Clin Pharmacol. 2009;49:6
  31. Oikarinen L, Viitasalo M, Korhonen P, et al. Postmyocardial infarction patients susceptible to ventricular tachycardia show increased T wave dispersion independent of delayed ventricular conduction. J Cardiovasc Electrophysiol. 2001;12:1115
  32. Kanters JK, Haarmark C, Vedel-Larsen E, et al. T-peak to T-end (TpTe) interval in long QT syndrome. J Electrocardiol. 2008;41:603
  33. De Luca G, Suryapranata H, Zijlstra F, et al. Symptom-onset-to-balloon time and mortality in patients with acute myocardial infarction treated by primary angioplasty. J Am Coll Cardiol. 2003;42:991
  34. Cannon CP, Gibson CM, Lambrew CT, et al. Relationship of symptom-onset-to-balloon time and door-to-balloon time with mortality in patients undergoing angioplasty for acute myocardial infarction. JAMA. 2000;283:2941

☆ The study was supported by the Danish Heart Foundation, John and Tove Girotti's Foundation, Danish National Research Foundation, King Christian X' Foundation and Lægernes Forsikringsforening.

PII: S0022-0736(09)00254-4

doi: 10.1016/j.jelectrocard.2009.06.009

Journal of Electrocardiology
Volume 42, Issue 6 , Pages 555-560 , November 2009

Article Tools

* Image Usage & Resolution