Arif Suner, Erdogan Yasar, Hakan Kaya, Sedat Koroglu, Abdulmecit Afsin, Durdu Eren Cabioglu, Mehmet Akgongor, Mustafa Yolcu, Kader Elis Sahin and Sabri Abus
Objective: Slow coronary flow (SCF) is characterized by angiographically normal coronary arteries with delayed opacification of the distal vasculature. The peak to the end of the electrocardiographic T wave (Tp-e) may correspond to the transmural dispersion of repolarization and that increased Tp-e interval and Tp-e/QT ratio are associated with ventricular arrhythmias. Neutrophil to lymphocyte ratio (NLR) is a new inflammatory marker using for cardiovascular risk prediction. The aim of this study was to evaluate the relationship between ventricular repolarization and inflammation in patients with SCF.
Methods: Forty-six SCF patients and 44 controls were enrolled to the study. Coronary flow rates were measured by Thrombolysis in Myocardial Infarction frame count (TFC). Tp-e interval and Tp-e/QT ratio were measured from a 12-lead electrocardiogram, and Tp-e interval was corrected for heart rate (cTp-e). NLR was calculated as the ratio of neutrophil to lymphocyte count. These parameters were compared between groups.
Results: Corrected Tp-e interval and Tp-e/QT ratio were significantly higher in SCF patients (94.5 ± 14.9 vs 88.1 ± 6.3 ms, 0.23 ± 0.03 vs 0.21 ± 0.02; P=0.009, and P=0.002, respectively). Also, NLR was increased in SCF patients (2.40 ± 0.9 vs 1.67 ± 0.5, P<0.001). The cTp-e was significantly correlated with mean TFC and NLR (r=0.50, p<0.001 and, r=0.37, p<0.001, respectively). Tp-e/QT ratio was significantly correlated with mean TFC and NLR (r=0.48, P<0.001 and r=0.28, P=0.006, respectively).
Conclusion: Our study revealed that cTp-e interval and Tp-e/QT ratio were increased in SCF patients. These new electrocardiographic ventricular repolarization indexes were significantly correlated with the mean TFC and NLR.