Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Sep 3:15:99.
doi: 10.1186/s12872-015-0091-4.

Prognostic value of Tpeak-Tend interval in patients with acute pulmonary embolism

Abdullah Icli  1 , Mehmet Kayrak  2 , Hakan Akilli  3 , Alpay Aribas  4 , Mukremin Coskun  5 , Sumeyye Fatma Ozer  6 , Kurtulus Ozdemir  7
Affiliations

Prognostic value of Tpeak-Tend interval in patients with acute pulmonary embolism

Abdullah Icli et al. BMC Cardiovasc Disord. .

Abstract

Background: The aim of this study was to examine the Tpeak-Tend (Tpe/corrected Tpe) interval, which is an indicator of transmural myocardial repolarization, measured non-invasively via electrocardiogram in patients with acute pulmonary embolism (PE), and to investigate the relationship with 30-day mortality and morbidity.

Methods: The study included 272 patients diagnosed with acute PE, comprising 154 females and 118 males, with a mean age of 63.1 ± 16.8 years. Tpe/cTpe intervals were calculated from the electrocardiograms with a computer program after using a ruler or vernier caliper manual measuring tool to obtain highly sensitive measurements. The relationship between the electrocardiogram values and 30-days mortality and morbidity were measured.

Results: The study group was divided into three groups according to cTpe intervals: Group 1, < 113 ms; Group 2, 113-133 ms; and Group 3, > 133 ms. White blood cell count and troponin T levels, corrected QT intervals with QRS complex durations, percentage of right ventricle dilatation with right/left-ventricular ratio, 30-day death, and combinations of these values were seen at a higher rate in Group 3 patients compared to the other groups. Kaplan-Meier analysis showed that the cTpe interval measured at > 126 ms could be used as a cut-off value in the prediction of mortality and morbidity. The cTpe cut-off values of 126 ms had sensivity, specificity, negative predictive value, and positive predictive value of 80.56 %, 59.32 %, 95.2 %, and 23.2 %, respectively.

Conclusions: cTpe interval could be a useful method in early risk stratification in patients with acute PE.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flow chart of the study design. WBC:white blood cell count; PLT: platelet count; HGB: haemoglobin
Fig. 2
Fig. 2
measurement of Tp-e via the tangent method with a computer program
Fig. 3
Fig. 3
Optimal cTp-e cutoff value for 30-day mortality was determined as 126 ms with ROC analysis. cTp-e cutoff value of 126 ms had sensivity, specificity, negative predictive value and positive predictive value of 80,56 %, 59,32 %, 95,2 % and 23,2 %, respectively
Fig. 4
Fig. 4
Patients with cTp-e > 126 ms had significantly lower 30-day survival rate in Kaplan- Meier curve (Fig. 4). We stratified the whole study population into cTp-e tertiles and suvival curve of the three tertile was significantly lower compared with other tertiles
See this image and copyright information in PMC

References

    1. Laack TA, Goyal DG. Pulmonary embolism: An unsuspected killer. Emerg Med Clin N Am. 2004;22:961–983. doi: 10.1016/j.emc.2004.05.011. - DOI - PubMed
    1. Stein PD, Henry JW. Prevalence of acute pulmonary embolism among patients in a general hospital and at autopsy. Chest. 1995;108(4):978–981. doi: 10.1378/chest.108.4.978. - DOI - PubMed
    1. Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, et al. Guidelines on diagnosis and management of acute pulmonary embolism. 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Endorsed by the European Respiratory Society (ERS) Eur Heart J. 2014;35(43):3033–3073. doi: 10.1093/eurheartj/ehu283. - DOI - PubMed
    1. Lucassen W, Geersing GJ, Erkens PM, Reitsma JB, Moons KG, Büller H, et al. Clinical decision rules for excluding pulmonary embolism: A meta-analysis. Ann Intern Med. 2011;155(7):448–460. doi: 10.7326/0003-4819-155-7-201110040-00007. - DOI - PubMed
    1. Laporte S, Mismetti P, De’cousus H, Uresandi F, Otero R, Lobo JL, et al. Clinical predictors for fatal pulmonary embolism in 15,520 patients with venous thromboembolism: Findings from the Registro Informatizado de la Enfermedad Trombo Embolicavenosa (RIETE) Registry. Circulation. 2008;117(13):1711–1716. doi: 10.1161/CIRCULATIONAHA.107.726232. - DOI - PubMed