ArticleBMC cardiovascular disorders2025
The relationship between 24-hour QT interval variability and heart rate variability in patients with acute myocardial infarction and the occurrence of major cardiovascular adverse events after PCI surgery.
Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAcute myocardial infarction (AMI) remains a significant cause of morbidity and mortality despite advancements in percutaneous coronary intervention (PCI). This study investigates whether 24-hour QT interval variability (QTV) and heart rate variability (HRV) can predict major adverse cardiovascular events (MACE) post-PCI.
methodsWe conducted a retrospective case-control study involving 238 AMI patients undergoing PCI between June 2021 and January 2023. Patients were divided into MACE (n = 96) and non-MACE (n = 142) groups. Variability in QT interval and HRV was assessed via continuous ECG monitoring pre- and post-PCI using a Holter recorder with a sampling rate of 1000 Hz. QT variability index (QTVI) and other QT measures were evaluated for their predictive power regarding MACE occurrence. All QT interval measurements were corrected using the Fridericia formula (QTcF).
resultsAnalysis revealed that the corrected QT interval (QTcF) was significantly prolonged in the MACE group compared with the non-MACE group (425.34 ± 42.15 ms vs. 410.28 ± 33.47 ms, P = 0.004). Additionally, the standard deviation of QT intervals (QT-SD) was significantly greater in the MACE group (7.80 ± 1.07 ms vs. 7.54 ± 0.33 ms, P = 0.023).The QTVI was higher in the MACE group (-0.60 ± 0.11 vs. -0.65 ± 0.21, P = 0.007), as was the normalized QT variance (QTVN, calculated as QTv/QTm²)(0.38 ± 0.07 vs. 0.36 ± 0.04, P = 0.010). There was a significant correlation between hypertension and MACE occurrence (P = 0.006), and elevated pulmonary artery systolic pressure was more prominent in the MACE group (25.66 ± 3.14 mmHg vs. 23.77 ± 6.58 mmHg, P = 0.003). ROC analysis showed that combining QTVI with clinical variables achieved an AUC of 0.78 (95% CI: 0.72-0.84).
conclusionQTV is a significant predictor of MACE post-PCI in AMI patients, underscoring its potential utility in post-procedural monitoring and risk stratification.
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