title: Frontal planar QRS/T angle can be a prognostic factor in the early postoperative period of patients undergoing coronary bypass surgery.
abstract: BACKGROUND
  Wide QRS/T angle reflects the ventricular repolarization heterogeneity and has been found in association with cardiac morbidity and mortality in various study populations. However, literature data about the availability of QRS/T angle in patients undergoing cardiac surgery has not yet been available.
  
  
  METHODS
  A total of 157 patients who underwent isolated coronary artery bypass surgery were included in this study. A preoperative 12-lead ECG was obtained one day before surgical procedure. The absolute difference between the frontal QRS wave axes and T-wave axes was defined as frontal planar QRS/T angle. Afterwards, patients were divided into two groups according to their frontal planar QRS/T angle (the cut-off value as 90°).
  
  
  RESULTS
  Group 1 consisted of 109 patients with frontal planar QRS/T angle of <90, and the remaining 48 patients with frontal planar QRS/T angle 90 were placed into group 2. Mean EuroSCORE was much higher in group 2. There were significant differences for positive inotropic agent usage (27.5% for group 1 versus 58.3% for group 2, P < .001) and the prevalence of postoperative atrial fibrillation (11.9% for group 1 versus 31.2% for group 2, P = .004) between the two groups. In multivariate logistic regression analysis, used to determine the independent predictors of positive inotropic usage in the early postoperative period, only frontal planar QRS/T angle (OR: 0.989, 95% CI: 0.981-0.997, P = .008) and EuroSCORE (OR: 0.792, 95% CI: 0.646-0.971, P = .025) were found to be statistically significant.
  
  
  CONCLUSIONS
  We found that frontal planar QRS/T angle might be an important preoperative parameter in predicting the need for inotropic drugs in the early postoperative period following coronary artery bypass surgery.
authors.affiliation: Department of Cardiovascular Surgery, Gülhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Kubilay
authors.initials: K
authors.lastname: Karabacak
authors.affiliation: Department of Cardiology, Gülhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Celik
authors.affiliation: Department of Cardiology, Gülhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Yalcin
authors.initials: Y
authors.lastname: Gokoglan
authors.affiliation: Department of Cardiovascular Surgery, Gülhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Kadan
authors.affiliation: Department of Cardiovascular Surgery, Gülhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Kaya
authors.affiliation: Department of Cardiovascular Surgery, Gülhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Suat
authors.initials: S
authors.lastname: Doganci
authors.affiliation: Department of Anesthesiology, Gülhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Vedat
authors.initials: V
authors.lastname: Yildirim
authors.affiliation: Department of Cardiovascular Surgery, Gülhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Ufuk
authors.initials: U
authors.lastname: Demirkilic
mesh_terms: D002316:Cardiotonic Agents / Q000627:therapeutic use*; D001026:Coronary Artery Bypass; D004562:Electrocardiography / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D011184:Postoperative Period; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
chemical_list: D002316:Cardiotonic Agents