QRS-T-angle in Patients with ST-Segment Elevation Myocardial Infarction (STEMI) - a Comparison with Cardiac Magnetic Resonance Imaging

Int J Med Sci. 2020 Aug 25;17(15):2264-2268. doi: 10.7150/ijms.44312. eCollection 2020.

Abstract

Background: The QRS-T angle from the surface EKG is a promising prognostic marker in patients with coronary artery disease. Cardiovascular magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE) offers high resolution imaging of myocardial damage. We investigated the association of the QRS-T angle and the extent of myocardial damage as assessed by LGE in patients with acute ST-segment myocardial infarction (STEMI) Methods: 169 patients with STEMI obtained a standardized digital 12-lead EKG on admission for the calculation of the QRS-T angle and underwent CMR imaging for analysis of infarct size by LGE within the first week. Patients were divided into groups: (1) abnormal QRS-T angle ≥ 90 degree and (2) QRS-T angle < 90 degree. Results: Patients with a QRS-T angle of 90 degree or more had larger infarcts (36.5±12.4 vs. 13.3±9.5; p<0.001) and lower ejection fraction (42.9±12.1% vs. 50.6±10.6%; p<0.001). Conclusion: The extent of myocardial damage as measured by the gold standard LGE is associated with a larger QRS-T angle calculated from the surface EKG.

Keywords: QRS-T angle; ST-segment elevation myocardial infarction; cardiovascular magnetic resonance; late gadolinium enhancement.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Aged
  • Contrast Media / administration & dosage
  • Electrocardiography*
  • Female
  • Gadolinium / administration & dosage
  • Heart / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • ST Elevation Myocardial Infarction / diagnosis*
  • Severity of Illness Index

Substances

  • Contrast Media
  • Gadolinium