Evidence map›Paper›PMID 28949056›Full record

Trial reportAnnals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc2018

Marked exercise-induced T-wave heterogeneity in symptomatic diabetic patients with nonflow-limiting coronary artery stenosis.

Fernando G Stocco, Ederson Evaristo, Nishant R Shah, Michael K Cheezum, Jon Hainer, Courtney Foster, Bruce D Nearing, Ernest Gervino, Richard L Verrier

Registry-linked trialAbstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01754259 (Effects of Ranolazine on Coronary Flow Reserve in Symptomatic Patients With Diabetes and Suspected or Known Coronary Artery Disease), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01754259 phase3completednot on this map

Effects of Ranolazine on Coronary Flow Reserve in Symptomatic Patients With Diabetes and Suspected or Known Coronary Artery Disease

TypeinterventionalSponsorBrigham and Women's HospitalRan2013 to 2015Enrolled47ConditionsDiabetes, Type I, Diabetes, Type II, Angina, Coronary Artery DiseaseArmsRanolazine, Placebo
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. The Diagnostic Value of ECG Characteristics for Vasospastic and Microvascular Angina: A Systematic Review.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2024
    Pooled it
  2. Marked exercise-induced T-wave heterogeneity in symptomatic diabetic patients with nonflow-limiting coronary artery stenosis.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2018
    Trial
  3. T-Wave Indices and Atherosclerosis.Current atherosclerosis reports · 2018
    Review
  4. Dysfunctional Nav1.5 channels due to SCN5A mutations.Experimental biology and medicine (Maywood, N.J.) · 2018
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 2 countries.

Fernando G StoccoUniversity of Sao Paulo School of Medicine, Sao Paulo, Brazil.
Ederson EvaristoUniversity of Sao Paulo School of Medicine, Sao Paulo, Brazil.
Nishant R ShahBrigham & Women's Hospital, Boston, MA, USA.
Michael K CheezumBrigham & Women's Hospital, Boston, MA, USA.
Jon HainerBrigham & Women's Hospital, Boston, MA, USA.
Courtney FosterBrigham & Women's Hospital, Boston, MA, USA.
Bruce D NearingBeth Israel Deaconess Medical Center, Boston, MA, USA.
Ernest GervinoBeth Israel Deaconess Medical Center, Boston, MA, USA.
Richard L VerrierBeth Israel Deaconess Medical Center, Boston, MA, USA.ORCID http://orcid.org/0000-0001-5602-6793
Beth Israel Deaconess Medical Center · USBrigham and Women's Hospital · US

Funding

Noninvasive Cardiovascular Imaging Research Training ProgramT32HL094301 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI Marcelo F DI CARLI · 2010 to 2026
$7.8M
Develop Patient Centered Outcomes Scholars for Comparative Effectiveness ResearchK12HS022998 · AHRQ · BROWN UNIVERSITY · PI TRIKALINOS, THOMAS · 2014 to 2018
$3.4M
AHRQ HHS K12 HS022998NHLBI NIH HHS T32 HL094301
6 · The paper itself

Abstract

backgroundT-wave heterogeneity (TWH) independently predicted cardiovascular mortality in Health Survey 2000 based on 12-lead ECGs recorded at rest. We investigated whether TWH is elevated during exercise tolerance testing (ETT) in symptomatic diabetic patients with nonflow-limiting coronary artery stenosis compared to control subjects without diabetes.

methodsCases were all patients (n = 20) with analyzable ECG recordings during both rest and ETT who were enrolled in the Effects of Ranolazine on Coronary Flow Reserve (CFR) in Symptomatic Patients with Diabetes and Suspected or Known Coronary Artery Disease (RAND-CFR) study (NCT01754259); median CFR was 1.44; 80% of cases had CFR <2. Control subjects (n = 9) were nondiabetic patients who had functional flow reserve (FFR) >0.8, a range not associated with inducible ischemia. TWH was analyzed from precordial leads V

resultsDuring exercise to similar rate-pressure products (p = .31), RAND-CFR patients exhibited a 49% increase in TWH during exercise (rest: 49 ± 5 μV; exercise: 73 ± 8 μV, p = .003). By comparison, in control subjects, TWH was not significantly altered (rest: 52 ± 11 μV; ETT: 38 ± 5 μV, p = .19). ETT-induced ST-segment depression >1 mm (p = .11) and T

conclusionsTWH is capable of detecting latent repolarization abnormalities, which are present during ETT in diabetic patients with nonflow-limiting stenosis but not in control subjects. The technique developed in this study permits TWH analysis from archived ECGs and thereby enables mining of extensive databases for retrospective studies and hypothesis testing.

Indexed as

Age FactorsCoronary AngiographyCoronary CirculationCoronary StenosisDiabetes MellitusElectrocardiographyExercise TestFemaleFollow-Up StudiesHumansMaleMiddle AgedPositron-Emission TomographyReference ValuesRisk AssessmentSeverity of Illness Indexcoronary artery diseasecoronary flow reservediabetesfunctional flow reserveheterogeneity

Identifiers

PMID28949056
PMCPMC6495190
OpenAlexW2757548922

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.