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European Journal of Heart Failure 2004 6(2):187-193; doi:10.1016/j.ejheart.2003.09.012
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© 2003 European Society of Cardiology

QT dispersion correlates to myocardial viability assessed by dobutamine stress echocardiography in patients with severely depressed left ventricular function due to coronary artery disease

Manolis Bountioukosa, Arend F.L. Schinkela, Don Poldermansa,*, Vittoria Rizzelloa, Eleni C. Vourvouria, Boudewijn J. Krenninga, Elena Biaginia, Jos R.T.C. Roelandta and Jeroen J. Baxb

a Thoraxcenter, Department of Cardiology Erasmus Medical Center, Rotterdam, The Netherlands
b Department of Cardiology Leiden University Medical Center, Leiden, The Netherlands

* Corresponding author. Tel.: +31-10-463-9222; fax: +31-10-463-4957. E-mail address: d.poldermans{at}erasmusmc.nl


  Abstract

Background: T dispersion is prolonged in numerous cardiac diseases, representing a general repolarization abnormality.

Aim: To evaluate the influence of viable myocardium on QT dispersion in patients with severely depressed left ventricular (LV) function due to coronary artery disease.

Methods and results: 103 patients with ischemic cardiomyopathy (LV ejection fraction [EF]: 25±6%) were studied. Patients underwent 12-lead electrocardiography to assess QT dispersion, and two-dimensional echocardiography to identify segmental dysfunction. Dobutamine stress echocardiography (DSE) was then performed to detect residual viability. Resting echo demonstrated 1260 dysfunctional segments; of these, 476 (38%) were viable. Substantial viability (≥4 viable segments on DSE) was found in 62 (60%) patients. QT dispersion was lower in these patients, than in patients without viability (55±17 ms vs. 65±22 ms, P=0.012). Viable segments negatively correlated to QT dispersion (r=–0.333, P=0.001). In contrast, there was no correlation between LVEF and QT dispersion (r=–0.001, P=NS).

Conclusions: There is a negative correlation between QT dispersion and the number of viable segments assessed by DSE. Patients with severely depressed LV function and a low QT dispersion probably have a substantial amount of viable tissue. Conversely, when QT dispersion is high, the likelihood of substantial viability is reduced.

Key Words: QT dispersion • Ischemic cardiomyopathy • Dobutamine stress echocardiography

Received April 15, 2003; Revised May 29, 2003; Accepted September 15, 2003


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