Improvement of the frontal QRS-T angle after successful percutaneous coronary revascularization in patients with chronic total occlusion.

Abstract

The QRS-T angle (QRS-Ta) is a novel marker of myocardial repolarization heterogeneity which is related to adverse cardiovascular events. Our aim in this study was to investigate the effect of successful percutaneous coronary intervention (PCI) on frontal QRS-Ta in patients with chronic total occlusion (CTO). A total of 132 patients undergoing PCI for CTO were included in this study. Successful PCI of CTO segment was performed in 84 patients (group 2) while 48 who failed CTO were observed (group 1). Baseline demographic and clinical variables were evaluated and, 12-lead surface ECGs of all subjects were recorded before performing coronary angiography and 1-month and 6-month after the index procedure. QRS-Ta values significantly decreased during follow-up visits compared to baseline values [92.5 (63.25-110.75); 85.0 (59.0-101.0); 80.0 (53.0-99.0), P < 0.001] in group 2 patients. Moreover, there was no significant difference in frontal QRS-Ta measurements in group 1 patients in their clinical 6-month follow-up [87.0 (48.25-103.0); 86.5 (46.0-101.75); 84.0 (49.0-103.75); P = 0.320]. First month frontal QRS-Ta values [92.5 (63.25-110.75); 85.0 (59.0-101.0), P = 0.002] and sixth month frontal QRS-Ta values [92.5 (63.25-110.75); 80.0 (53.0-99.0), P < 0.001] were lower than baseline values while sixth month values [85.0 (59.0-101.0); 80.0 (53.0-99.0), P = 0.002] was lower compared to first month values. Additionally, a decrease in frontal QRS-Ta was observed regardless of target vessel or Rentrop classification. Successful percutaneous revascularization of CTO was effective in ventricular repolarization. Frontal QRS-Ta significantly decreased after successful PCI on CTO patients at a 6-month follow-up.