Abstract
Background. Noninvasive diagnosis of coronary artery disease (CAD) represents a real problem in clinical practice and can be improved by use of novel additional Holter ECG options. Aim. To evaluate the markers of electrical inhomogeneity of repolarization process in patients with various degree of coronary atherosclerosis. Materials and methods. All 116 patients, hospitalized for diagnostic coronary angiography, were divided into three groups: 1 – severe coronary atherosclerosis, 2 – initial atherosclerosis, 3 – normal coronary arteries (control group). A 12-lead Holter electrocardiography was performed to evaluate microvolt T-wave alternans (MTWA), QT and QTc dispersion on maximal and minimal heart rate (QTdmax and QTcdmax, QTdmin and QTcdmin respectively). Results. Results of a comparative analysis have demonstrated significant differences between three mentioned groups referring to MTWA (p=0,015). QTdmax (p1-2<0.001, p1-3=0.002) as well as QTcdmax (p1-2<0.0001, p1-3=0.001) were significantly higher in group 1 compared to others. At the same time, QTdmin and QTcdmin values didn't differ between the groups. The results of a current study indicated increased absolute values of the markers of an impaired repolarization in individuals with severe coronary atherosclerosis (compared to initial atherosclerosis and normal coronary arteries). Conclusion. The markers of electrical inhomogeneity of repolarization process in the myocardium (MTWA, QTdmax and QTcdmax) represent perspective ECG instruments in evaluation of the severity of coronary atherosclerosis in patients with stable CAD, still requesting futher investigation.
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