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Diagnostic performance of T-axis deviation on 12-leads electrocardiography for myocardial ischemia: Analysis by semiconductor SPECT

Session Poster session 1

Speaker Masato Shimizu

Event : ESC Congress 2017

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease (Chronic)
  • Session type : Poster Session

Authors : M Shimizu (Yokohama,JP), Y Taomoto (Yokohama,JP), M Amemiya (Yokohama,JP), Y Yamakami (Yokohama,JP), Y Sato (Yokohama,JP), M Iiya (Yokohama,JP), R Nakamura (Yokohama,JP), K Nakano (Yokohama,JP), H Shimada (Yokohama,JP), H Fujii (Yokohama,JP), N Yamawake (Yokohama,JP), M Nishizaki (Yokohama,JP), H Sakurada (Tokyo,JP), M Hiraoka (Toride,JP)

M. Shimizu1 , Y. Taomoto1 , M. Amemiya1 , Y. Yamakami1 , Y. Sato1 , M. Iiya1 , R. Nakamura1 , K. Nakano1 , H. Shimada1 , H. Fujii1 , N. Yamawake1 , M. Nishizaki1 , H. Sakurada2 , M. Hiraoka3 , 1Yokohama Minami Kyosai Hospital, Department of Cardiology - Yokohama - Japan , 2Tokyo Metropolitan Okubo Hospital - Tokyo - Japan , 3Toride Kitasoma Medical Center Hospital - Toride - Japan ,

European Heart Journal ( 2017 ) 38 ( Supplement ), 196

Background: T-axis deviation (TAD) on 12-leads electrocardiography (ECG) is considered as an indicator or left ventricular (LV) repolarization abnormalities. However, there were few studies which estimated the diagnostic performance of TAD for myocardial ischemia by semiconductor SPECT system.

Purpose: To evaluate diagnostic performance of T-axis deviation for myocardial ischemia.

Methods: We enrolled consecutive 1033 sinus-rhythm patients (72±10 years old, 748 males), who underwent adenosine-stress SPECT and ECG simultaneously. Patients with normal T-axis (0 to +70 degree) were assigned to GroupA. Patients with TAD were assigned to GroupLAD (T-axis <0 degree) and GroupRAD (T-axis > +70 degree), according to previously reported normal range of T axis (Simonson. 1961)

Results: Group RAD had higher summed stress score (SSS) in anterior wall, and group LAD had higher SSS in lateral wall. Both groups had higher SSS in inferior wall (See Table). Multivariate analysis showed RAD and LAD had significant and independent high odds ratios for ischemia in each area (See Figure).

Conclusions: TAD had significant prognostic value, and RAD indicated myocardial ischemia in anterior wall, and LAD in lateral wall.

Comparison between three groups
Group AGroup LADGroup RADP value
T-axis (°)40.4±20.2-35.4±24.992.1±25.3
Age (y)71.0±10.272.4±10.673.4±9.3*0.002*
HR (bpm)68.8±11.767.9±11.767.8±11.70.435
QRS width (ms)95.1±18.096.9±20.396.2±19.70.522
EDV (mL)71.6±24.682.1±33.4*76.7±28.1*<0.001*
ESV (mL)30.2±18.740.4±29.7*36.6±24.0*<0.001*
LVEF (%)60.2±10.454.7±13.2*55.9±13.3*<0.001*
PFR (EDV/s)2.07±0.581.91±0.68*1.90±0.62*<0.001*
Bandwidth (°)57.2±31.173.8±56.9*68.5±50.2*<0.001*
SSS anterior1 [0, 3]1 [0, 3]2 [1, 6]*<0.001*
SSS inferior2 [1, 4]4 [1, 8]*3 [1, 5]*<0.001*
SSS lateral1 [0, 2]2 [0, 4]*1 [0, 2]<0.001*
ANOVA analysis and Kruskal Wallis analysis were underwent.

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