Correlation between Tp-Te Interval and Myocardial Blush Grade Value in Anterior ST Elevation Myocardial Infarction Patient

Rio Probo Kaneko (Department of Cardiology and Vascular Medicine Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada – Dr. Sardjito Hospital, Yogyakarta)
Erika Maharani (Department of Cardiology and Vascular Medicine Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada – Dr. Sardjito Hospital, Yogyakarta)
Nahar Taufiq (Department of Cardiology and Vascular Medicine Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada – Dr. Sardjito Hospital, Yogyakarta)

ACI (Acta Cardiologia Indonesiana)
Vol 4, No 2 (2018)

Background: Clinical manifestations of coronary herat disease (CHD) may be an ST-Elevation Myocardial Infarction (STEMI). In STEMI condition, there is a metabolic disorder and ion exchange disturbance which causes dispersion of transmural repolarization, as well as micro coronary circulation disturbance involving mechanism of microvascular dysfunction. The Tp-Te interval is an electrocardiogram paramener that could be described as the transmural dispersion of repolarization. Assessment of Myocardial Blush Grade (MBG) is a coronary angiography densitometry method that can be used to assess microvascular dysfunction. This study aims to examine the correlation between Tp-Te interval and MBG in anterior STEMI.Methods: The research desgin is cross sectional. Data were taken consecutive from August to November 2017. The Tp-Te interval assessment was performed on the basis of an electrocardiogram record from the subjects. The MBG value assessment was performed using a Quantitative Blush Evaluator (QuBE) computer program based on coronary angiography. The Tp-Te interval is divided into 2 groups: Tp-Te interval > 94 ms and Tp-Te interval ≤ 94 ms. The MBG values are divided into 3 groups: MBG QuBE 1, MBG QuBE 2 and MBG QuBE 3. The assessment of Tp-Te interval and MBG value was performed by observer in intra-observer which were acknowledged based on Kappa and blindness conformity test results against patient clinical data. Pearson correlation test was used to analyze the correlation between Tp-Te interval and MBG value, while logistic regression test was used for multivariate test.Results: Of the total 32 study subjects, there were 23 subjects with Tp-Te interval >94 ms and 9 subjects with Tp-Te interval ≤94 ms. There was a negative correlationwith moderate strength between the Tp-Te interval and the MBG value in the anterior STEMI patients (r =-0.501, p =0.004). There was a prevalence ratio of 4.304 between Tp-Te interval >94 milliseconds against MBG QuBE 1 (95%CI: 1.264-14.658, p <0.001). Multivariate tests showed Tp-Te intervals consistently as independent risk factors for MBG values in subjects with anterior STEMI.Conclusion: There is a negative correlation with moderate strength between the Tp-Te interval and the MBG value in the anterior STEMI patients.