title: Impact of Percutaneous Coronary Intervention on Exercise-Induced Repolarization Changes in Patients With Stable Coronary Artery Disease.
abstract: Recent reports suggest T peak to T end (Tpe) interval and Tpe/QT ratio as valuable indicators of increased arrhythmogenic risk in patients with coronary artery disease (CAD). We aimed to examine the exercise-induced changes in these indexes in patients with stable CAD, before and after percutaneous coronary intervention (PCI). Forty patients were consecutively included in the interventional group (n = 20), with significant lesions (≥75% luminal narrowing) suitable for PCI and in the control group (n = 20), with no significant coronary artery lesions (<50% luminal narrowing). One day before and 30 days after the coronarography, all patients performed treadmill exercise stress testing, and the electrocardiographic (ECG) indexes of repolarization were assessed during baseline and at peak exercise intensity. In the control group, the QT interval, QTc (QT-corrected) interval, Tpe interval, and Tpe/QT ratio measured at peak exercise significantly decreased from baseline values (p = 0.001, p = 0.004, p <0.001, and p = 0.017, respectively). Conversely, in interventional patients before the PCI, an increase in the Tpe interval and the Tpe/QT ratio was observed at exercise (p = 0.009, and p <0.001, respectively), with only the QT interval exhibiting a significant decrease from baseline (p <0.001). Thirty days after the PCI, all the ECG arrhythmogenic indexes measured at peak exercise significantly decreased from baseline values, thus assuming the same trend as detected in controls. In conclusion, restoration of blood supply normalized exercise-induced repolarization changes, suggesting that revascularization of previously ischemic myocardium lowers the cardiac arrhythmogenic potential in patients with stable CAD.
authors.affiliation: Department of Cardiology, University Hospital Centre Split, Split, Croatia.
authors.forename: Anita
authors.initials: A
authors.lastname: Jukić
authors.affiliation: Department of Cardiology, University Hospital Centre Split, Split, Croatia.
authors.forename: Vedran
authors.initials: V
authors.lastname: Carević
authors.affiliation: Department of Cardiology, Zadar Hospital Center, Zadar, Croatia.
authors.forename: Dražen
authors.initials: D
authors.lastname: Zekanović
authors.affiliation: Department of Anestesiology, Reanimatology and Intensive Care, University Hospital Centre Split, Split, Croatia.
authors.forename: Sanda
authors.initials: S
authors.lastname: Stojanović-Stipić
authors.affiliation: Department of Cardiology, University Hospital Centre Split, Split, Croatia.
authors.forename: Frane
authors.initials: F
authors.lastname: Runjić
authors.affiliation: Department of Integrative Physiology, University of Split School of Medicine, Split, Croatia.
authors.forename: Marko
authors.initials: M
authors.lastname: Ljubković
authors.affiliation: Department of Cardiology, University Hospital Centre Split, Split, Croatia. Electronic address: damir.fabijanic@st.t-com.hr.
authors.forename: Damir
authors.initials: D
authors.lastname: Fabijanić
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000503:physiopathology*; D015331:Cohort Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D016896:Treatment Outcome