Document Detail

Sensitivity and specificity of QTc dispersion for identification of risk of cardiac death in patients with peripheral vascular disease.
MedLine Citation:
PMID:  8611874     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether QTc dispersion, which is easily obtained from a standard electrocardiogram, can predict those patients with peripheral vascular disease who will subsequently suffer a cardiac death, despite having no cardiac symptoms or signs. DESIGN: Patients with peripheral vascular disease were followed up for five years after they had had coronary angiography, radionuclide ventriculography, and their QTc dispersion calculated from their 12 lead electrocardiogram. SUBJECTS: 49 such patients were then divided into three groups: survivors (34), cardiac death (12), and non-cardiac death (3). MAIN OUTCOME MEASURE: Survival. RESULTS: The mean (SD; range) ejection fractions were similar in all three groups: survivors 45.9 (11.0; 27.0-52.0), cardiac death 44.0 (7.90; 28.5-59.0), and non-cardiac death 45.3 (4.55; 39.0-50.0). QTc dispersion was significantly prolonged in the cardiac death group compared with in the survivors (86.3(23.9; 41.0-139) v 56.5 (25.4; 25.0-164); P = 0.002). A QTc dispersion > or = 60 ms had a 92% sensitivity and 81% specificity in predicting cardiac death, QTc dispersion in patients with diffuse coronary artery disease was significantly (P < 0.05) greater than in those with no disease or disease affecting one, two, or three vessels. CONCLUSIONS: There is a strong link between QTc dispersion and cardiac death in patients with peripheral vascular disease. QTc dispersion may therefore be a cheap and non-invasive way of assessing the risk of cardiac death in patients with peripheral vascular disease.
D Darbar; J Luck; N Davidson; T Pringle; G Main; G McNeill; A D Struthers
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BMJ (Clinical research ed.)     Volume:  312     ISSN:  0959-8138     ISO Abbreviation:  BMJ     Publication Date:  1996 Apr 
Date Detail:
Created Date:  1996-06-06     Completed Date:  1996-06-06     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  8900488     Medline TA:  BMJ     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  874-8; discussion 878-9     Citation Subset:  AIM; IM    
Department of Cardiology, Ninewells Hospital and Medical School, Dundee.
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MeSH Terms
Coronary Angiography
Death, Sudden, Cardiac*
Heart Rate
Middle Aged
Peripheral Vascular Diseases / mortality,  physiopathology*
Radionuclide Ventriculography
Risk Factors
Sensitivity and Specificity
Comment In:
BMJ. 1996 Oct 26;313(7064):1081, author reply 1082-3   [PMID:  8898617 ]
BMJ. 1996 Oct 26;313(7064):1081-2; author reply 1082-3   [PMID:  8898618 ]
BMJ. 1996 Oct 26;313(7064):1082; author reply 1082-3   [PMID:  8898619 ]
BMJ. 1996 Oct 26;313(7064):1082; author reply 1082-3   [PMID:  8898620 ]

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