Association Between Index of Cardio‐Electrophysiological Balance and Cardiac Remodeling

Öz

Objective: Pathophysiological changes in response to myocardial infarction (MI) result in cardiac remodeling. Left untreated this pathologic process contributes to impairment of ventricular function and development of malignant ventricular arrhythmias. Recently introduced ECG‐based marker index of cardio‐electrophysiological balance (iCEB) has been shown to be associated with various cardiac conditions. Herein, we aimed to investigate the association between the iCEB and cardiac remodeling in post-MI patients. Materials and Methods: Patients aged ≥18 years presenting with acute MI who underwent successful percutaneous coronary intervention between January 2020 and January 2021 were recruited. Regarding the assessment of cardiac remodeling, left ventricular (LV) mass, LV mass index (LVMI), and relative wall thickness (RWT) were measured before the start of treatment and six months after the procedure along with the QT/QRS ratio (iCEB), and QTC/QRS ratio (iCEBc). Results: According to our study, estimated QT/QRS (iECB) and QTc/QRS (iECBc) ratios were found to be significantly lower at six-month follow-up compared to baseline values (4.73∓0.60 vs 4.62∓0.55 & 4.93∓0.59 vs 4.78∓0.55, p<0.001 respectively). There were significant reductions of estimated LV mass and LVMI at six-month follow-up compared to baseline values (208.85∓40.30 g vs 198.15∓37.18 g & 108.21∓19.84 g/m2 vs 103.49∓19.58 g/m2, p<0.001 respectively). Both LVM and LVMI had a significant correlation with iCEB and iCEBc (p<0.001). Conclusion: Our results suggest that iCEB may potentially be a useful marker in terms of predicting cardiac remodeling.

Anahtar Kelimeler

• Cardiac remodeling
• left ventricular mass
• left ventricular mass index
• index of cardio‐electrophysiological balance

Kardiyak Yeniden Şekillenme ile Kardiyo-Elektrofizyolojik Denge İndeksi Arasındaki İlişki

Öz

Giriş ve Amaç: Miyokart enfarktüsüne yanıt olarak ortaya çıkan patofizyolojik değişiklikler, kardiyak yeniden şekillenme ile sonuçlanır. Tedavi edilmediği takdirde bu patolojik süreç, ventriküler fonksiyonun bozulmasına ve malign ventriküler aritmilerin gelişmesine neden olur. Son zamanlarda kullanılmaya başlanan EKG tabanlı kardiyo-elektrofizyolojik denge indeksinin çeşitli kardiyak durumlarla ilişkili olduğu gösterilmiştir. Bu çalışmada, miyokart enfarktüsü sonrası gelişen kardiyak yeniden şekillenme ile kardiyo-elektrofizyolojik denge indeksi arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmaya, Ocak 2020 ile Ocak 2021 arasında hastanemize akut miyokart enfarktüsü ile başvuran ve başarılı perkütan koroner girişim uygulanan 18 yaş ve üzeri hastalar dahil edildi. Kardiyak yeniden şekillenmenin değerlendirilmesi amacıyla; sol ventrikül (SV) kütlesi, sol ventrikül kütle indeksi (SVKİ) ve rölatif duvar kalınlığı (RDK), tedavi başlamadan önce ve işlemden altı ay sonra kardiyo-elektrofizyolojik denge indeksi parametreleri (QT/QRS, QTc/QRS) ile birlikte değerlendirildi. Bulgular: Çalışmamıza göre, altı aylık takip sonunda QT/QRS ve QTc/QRS değerleri başlangıç değerlerine göre anlamlı derecede düşük bulundu (4.73∓0.60 vs 4.62∓0.55 & 4.93∓0.59 vs 4.78∓0.55, sırasıyla p<0.001). Başlangıç değerlerine kıyasla SV kütle ve SVKİ değerlerinde anlamlı düşüşler tespit edildi (208.85∓40.30 g vs 198.15∓37.18 g & 108.21∓19.84 g/m2 vs 103.49∓19.58 g/m2, sırasıyla p<0.001). Hem SV kütle hem de SVKİ, kardiyo-elektrofizyolojik denge indeksi parametreleri ile anlamlı bir korelasyona sahipti (p<0,001). Sonuç: Sonuçlarımız, kardiyo-elektrofizyolojik denge indeksi parametrelerinin kardiyak yeniden şekillenmeyi öngörme açısından potansiyel olarak yararlı bir belirteç olabileceğini düşündürmektedir.

Anahtar Kelimeler

• Kardiyak yeniden şekillenme
• Sol ventrikül kütlesi
• Sol ventrikül kütle indeksi
• Kardiyo-elektrofizyolojik denge indeksi

Kaynakça

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