Objective: To explore the diagnostic and prognostic value of Tp-Te/QT ratio and serum Ang Ⅱ level in patients with acute coronary syndrome (ACS). Methods: A total of 243 patients who were admitted to the hospital for coronary angiography due to chest pain were selected and divided into the negative control group (CON group), unstable angina group (UAP group) and myocardial infarction group (AMI group) according to the results of the angiography. Tp-Te/QT ratio was tested and serum Ang Ⅱ levels were detected using enzyme-linked immunosorbent assay (ELISA) to evaluate the diagnostic and prognostic value of Tp-Te/QT ratio and Ang Ⅱ levels in patients with ACS. Results: Compared with the CON group, the UAP group had higher age, TC level and longer Tp-Te interval (P＜0.05). Compared with the CON and UAP group, the levels of SCr, TC, D-dimer and Ang Ⅱ, the Tp-Te interval and Tp-Te/QT ratio of the AMI group had were significantly increased (P＜0.05). The results of binary logistic regression analysis showed that Tp-Te/QT ratio and Ang Ⅱ levels were independent predictors in AMI diagnosis. The receiver operating characteristic curve(ROC curve) indicated that the best cut-off value of Tp-Te/QT is 0.29 (sensitivity 55.6 %, specificity 80.7 %), and the best cut-off value of Ang Ⅱ level is 49.50mg/L (sensitivity 83.3 %, specificity 49.8 %) ), the combined prediction of the two indicators can improve the diagnostic specificity (sensitivity 63.9 %, specificity 85.5 %). Binary logistic regression analysis suggested that Tp-Te/QT ratio and serum Ang Ⅱ levels were independent risk factors for MACE events (P＜0.05 ), and ROC results showed that the best cut-off value of Tp-Te/QT to evaluate MACE events was 0.30 (sensitivity 66.70 %, specificity 89.20 %), and the best cut-off value of Ang Ⅱ level was 66.50 mg/L (sensitivity 75 %, specificity 93.2 %), the combined prediction of the two indicators can improve the diagnostic sensitivity (sensitivity 87.50 %, specificity 89.80 %). Conclusion: Tp-Te/QT ratio and Ang Ⅱ level have certain predictive value in acute myocardial infarction (AMI) diagnosis and MACE event evaluation, and the combination of the two indicators can improve the specificity of AMI diagnosis and the sensitivity of MACE event evaluation.
RONG Li
,
CHENG Wei
,
ZHAO Sheng
,
LI Tianyu
,
WANG Chan
,
CHEN Houliang
,
GAO Yanlin
. Diagnostic and prognostic value of Tp-Te/QTc ratio and Ang Ⅱ level in patients with ACS[J]. Journal of Baotou Medical College, 2023
, 39(9)
: 28
-33
.
DOI: 10.16833/j.cnki.jbmc.2023.09.006
[1] Boduroglu Y,Son O. Assessment of tp-Te interval and tp-Te/qt ratio in patients with aortic aneurysm[J].Open Access Maced J Med Sci,2019,7(6): 943-948.
[2] 段雯婷,路轶晴,马欣,等. QRS碎裂波结合血浆差异代谢物在急性心肌梗死早期诊断中的应用[J].临床心血管病杂志,2020,36(9): 810-815.
[3] 张勇,张奇,王德国,等. 心电图Selvester QRS积分评价急性病毒性心肌炎并发左心功能异常的临床价值[J].临床心血管病杂志,2021,37(2): 137-140.
[4] 周鹏,杨慧,陈咏华,等. 老年急性肺栓塞心电图变化特点与临床预后的关系分析[J].中华全科医学,2020,18(1): 52-55.
[5] 黄永平,张勇,王德国,等. 急性蛛网膜下腔出血患者入院心电图异常对住院预后的判断作用[J].九江学院学报(自然科学版),2020,35(1): 90-95.
[6] 王静,高敏,郑安然. 心电图Tp-Tec,QTc,Tp-Te/QT比值与急性心肌梗死患者急性期发生室性心律失常的关系[J].临床与病理杂志,2019,39(5): 965-970.
[7] Yin XC,Zhang SL,Liu HR. Multiple regulatory effects of angiotensin Ⅱ on the large-conductance Ca2+-and voltage-activated potassium channel in vascular smooth muscle cells[J].生理学报,2019,71(2): 187-195.
[8] Buttà C,Zappia L,Laterra G,et al. Diagnostic and prognostic role of electrocardiogram in acute myocarditis: a comprehensive review[J].Ann Noninvasive Electrocardiol,2020,25(3): e12726.
[9] Giudicessi JR,Roden DM,Wilde AAM,et al. Classification and reporting of potentially proarrhythmic common genetic variation in long QT syndrome genetic testing[J].Circulation,2018,137(6): 619-630.
[10] 陈锐,李政宁,黄英华,等. 院前急救心力衰竭患者血浆BNP与心电图QRS波时限及Tp-Te间期的相关性[J].中国老年学杂志,2019,39(15): 3608-3610.
[11] Rautaharju PM,Zhang ZM,Gregg RE,et al. Normal standards for computer-ECG programs for prognostically and diagnostically important ECG variables derived from a large ethnically diverse female cohort: the Women's Health Initiative (WHI)[J].J Electrocardiol,2013,46(6): 707-716.
[12] Morin DP,Saad MN,Shams OF,et al. Relationships between the T-peak to T-end interval,ventricular tachyarrhythmia,and death in left ventricular systolic dysfunction[J].Europace,2012,14(8): 1172-1179.
[13] 王静,高敏,郑安然. 心电图Tp-Tec,QTc,Tp-Te/QT比值与急性心肌梗死患者急性期发生室性心律失常的关系[J].临床与病理杂志,2019,39(5): 965-970.
[14] Shenthar J,Deora S,Rai M,et al. Prolonged Tpeak-end and Tpeak-end/QT ratio as predictors of malignant ventricular arrhythmias in the acute phase of ST-segment elevation myocardial infarction: a prospective case-control study[J].Heart Rhythm,2015,12(3): 484-489.
[15] Almengló C,Couselo-Seijas M,Agra RM,et al. Soluble angiotensin-converting enzyme levels in heart failure or acute coronary syndrome: revisiting its modulation and prognosis value[J].J Mol Med (Berl),2021,99(12): 1741-1753.
[16] Chrysant SG,Chrysant GS. Dual renin-angiotensin-aldosterone blockade: promises and pitfalls[J].Curr Hypertens Rep,2015,17(1):511.
[17] Cao W,Song S,Fang GJ,et al. Cadherin-11 deficiency attenuates ang-II-induced atrial fibrosis and susceptibility to atrial fibrillation[J].J Inflamm Res,2021,14: 2897-2911.
[18] 黎秀芝,尹新华. ACE2/Ang(1-7)/Mas轴在心血管疾病中的研究进展[J].医学综述,2020,26(20): 3969-3975.
[19] Wu HY,Shou XL,Liang L,et al. Correlation between plasma angiopoietin-1,angiopoietin-2 and matrix metalloproteinase-2 in coronary heart disease[J].Arch Med Sci,2016,12(6): 1214-1219.
