The diagnostic utility of the basal and post‐exercise QRS‐T angle in patients with stable coronary artery disease
Abstract Background To evaluate the diagnostic utility of basal and post‐exercise QRS‐T angle in patients with stable coronary artery disease (CAD). Methods This cross‐sectional and observational study analyzed 190 patients with stable angina. The QRS‐T angle is measured on the 12‐lead electrocardio...
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| Format: | Article |
| Language: | English |
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Wiley
2023-09-01
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| Series: | Annals of Noninvasive Electrocardiology |
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| Online Access: | https://doi.org/10.1111/anec.13082 |
| _version_ | 1827825311791710208 |
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| author | Tufan Günay Alper Karakus |
| author_facet | Tufan Günay Alper Karakus |
| author_sort | Tufan Günay |
| collection | DOAJ |
| description | Abstract Background To evaluate the diagnostic utility of basal and post‐exercise QRS‐T angle in patients with stable coronary artery disease (CAD). Methods This cross‐sectional and observational study analyzed 190 patients with stable angina. The QRS‐T angle is measured on the 12‐lead electrocardiograms at baseline and just after stopping the treadmill stress test in patients undergoing conventional coronary angiography (CAG). The pre‐ and post‐exercise QRS‐T angle and ΔQRS‐T angle were analyzed. Results Of the 190 patients, 66 (34.7%) were assigned to group 1 (patients with coronary lesion) and 124 (65.3%) to group 2 (patients without coronary lesion) after CAG. There was no statistically significant difference in QRS‐T angle between groups at baseline (pre‐exercise) (30.7 ± 17 vs. 27.8 ± 12.8, p = .233). The QRS‐T angle value was significantly higher in group 1 than in group 2 (68.8 ± 40.3 vs. 22.7 ± 21.5, p = .01) after exercise (post‐exercise). The ΔQRS‐T angle was also significantly higher in group 1 than in group 2 (38.1 ± 37.6 vs. −5.1 ± 22.9, p = .01). Receiver operating characteristic curve revealed that the cut‐off value of QRS‐T angle (post‐exercise) for the coronary obstruction was >51.5° with 81% of sensitivity and 66% of specificity (AUC: 0.832, p = .001, CI: 0.769–0.894). Duke treadmill score for coronary stenosis was >1.5 with 77% of sensitivity and 69% of specificity (AUC: 0.814, p = .001, CI: 0.749–0.878). Conclusion It could be proposed that post‐exercise QRS‐T angle and Δ QRS‐T angle are significantly associated with coronary obstruction in patients with stable angina and appear to be more sensitive than the Duke treadmill score and traditional electrocardiographic parameters. |
| first_indexed | 2024-03-12T02:40:19Z |
| format | Article |
| id | doaj.art-8108ae2e0a654b23bc3944f0f82fac1c |
| institution | Directory Open Access Journal |
| issn | 1082-720X 1542-474X |
| language | English |
| last_indexed | 2024-03-12T02:40:19Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Noninvasive Electrocardiology |
| spelling | doaj.art-8108ae2e0a654b23bc3944f0f82fac1c2023-09-04T07:18:40ZengWileyAnnals of Noninvasive Electrocardiology1082-720X1542-474X2023-09-01285n/an/a10.1111/anec.13082The diagnostic utility of the basal and post‐exercise QRS‐T angle in patients with stable coronary artery diseaseTufan Günay0Alper Karakus1Department of Cardiology Health Sciences University, Bursa City Hospital Bursa TurkeyDepartment of Cardiology Health Sciences University, Bursa Yüksek Ihtisas Training and Research Hospital Bursa TurkeyAbstract Background To evaluate the diagnostic utility of basal and post‐exercise QRS‐T angle in patients with stable coronary artery disease (CAD). Methods This cross‐sectional and observational study analyzed 190 patients with stable angina. The QRS‐T angle is measured on the 12‐lead electrocardiograms at baseline and just after stopping the treadmill stress test in patients undergoing conventional coronary angiography (CAG). The pre‐ and post‐exercise QRS‐T angle and ΔQRS‐T angle were analyzed. Results Of the 190 patients, 66 (34.7%) were assigned to group 1 (patients with coronary lesion) and 124 (65.3%) to group 2 (patients without coronary lesion) after CAG. There was no statistically significant difference in QRS‐T angle between groups at baseline (pre‐exercise) (30.7 ± 17 vs. 27.8 ± 12.8, p = .233). The QRS‐T angle value was significantly higher in group 1 than in group 2 (68.8 ± 40.3 vs. 22.7 ± 21.5, p = .01) after exercise (post‐exercise). The ΔQRS‐T angle was also significantly higher in group 1 than in group 2 (38.1 ± 37.6 vs. −5.1 ± 22.9, p = .01). Receiver operating characteristic curve revealed that the cut‐off value of QRS‐T angle (post‐exercise) for the coronary obstruction was >51.5° with 81% of sensitivity and 66% of specificity (AUC: 0.832, p = .001, CI: 0.769–0.894). Duke treadmill score for coronary stenosis was >1.5 with 77% of sensitivity and 69% of specificity (AUC: 0.814, p = .001, CI: 0.749–0.878). Conclusion It could be proposed that post‐exercise QRS‐T angle and Δ QRS‐T angle are significantly associated with coronary obstruction in patients with stable angina and appear to be more sensitive than the Duke treadmill score and traditional electrocardiographic parameters.https://doi.org/10.1111/anec.13082coronary artery diseaseDuke treadmill scoreQRS‐T angletreadmill stress test |
| spellingShingle | Tufan Günay Alper Karakus The diagnostic utility of the basal and post‐exercise QRS‐T angle in patients with stable coronary artery disease Annals of Noninvasive Electrocardiology coronary artery disease Duke treadmill score QRS‐T angle treadmill stress test |
| title | The diagnostic utility of the basal and post‐exercise QRS‐T angle in patients with stable coronary artery disease |
| title_full | The diagnostic utility of the basal and post‐exercise QRS‐T angle in patients with stable coronary artery disease |
| title_fullStr | The diagnostic utility of the basal and post‐exercise QRS‐T angle in patients with stable coronary artery disease |
| title_full_unstemmed | The diagnostic utility of the basal and post‐exercise QRS‐T angle in patients with stable coronary artery disease |
| title_short | The diagnostic utility of the basal and post‐exercise QRS‐T angle in patients with stable coronary artery disease |
| title_sort | diagnostic utility of the basal and post exercise qrs t angle in patients with stable coronary artery disease |
| topic | coronary artery disease Duke treadmill score QRS‐T angle treadmill stress test |
| url | https://doi.org/10.1111/anec.13082 |
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