QT dispersion within the first 6 months after an acute myocardial infarction:: Relationship with systolic function, left ventricular volumes, infarct related artery status and clinical outcome

Abstract

Introduction: We analysed QT dispersion within the first 6 months postinfarction, its relationship with the main established risk stratifiers and its clinical value. Methods and results: In 55 patients with a first Q-wave myocardial infarction the 12-lead electrocardiogram was scanned and digitised for analysis of QT dispersion (QT maximum–QT minimum) at first day (72 [61–96] ms), first week (69 [47–90] ms), first month (67 [46–88] ms) and sixth month (47 [40–74] ms; P<0.0001 vs. first day). Cardiac catheterization was performed at first week and at sixth month; QT dispersion was not related to ejection fraction, left ventricular volumes, infarct related artery status or contractile reserve (improvement of the infarcted area with low-dose dobutamine); no relation was found between QT dispersion decrease from first week to sixth month with regional systolic function improvement. Finally, during a mean follow-up period of 35±22 months QT dispersion was not independently related to clinical events. Conclusion: QT dispersion decreases progressively during the first months after myocardial infarction. These changes should be taken into account to define cut-off values of clinical interest in this phase. This variable does not seem related to the classic prognosis predictors. In a nonselected postinfarction population it has a low clinical value.