ECG changes and markers of increased risk of arrhythmia in patients with myocardial bridge

Abstract

Background: The clinical significance and prognosis of myocardial bridge (MB) is still a matter of debate.

Objectives: To assess the novel ECG markers of T peak-to-end (Tp-e) interval, transmural dispersion of repolarization (TDR), is assessed by Tp-e/QT ratio, and index of electrophysiogical index(iCEB),is defined by QT/QRS ratio and changes (ST-T changes) in MB patients.

Patients and methods: Forty one patients who were diagnosed as having MB (MB group) and other 41 patients without MB (non-MB group) at multi-detector CT (MDCT) exam matched by age, sex were enrolled in the study.

Results: iCEB was significantly increased in MB group in comparison to non-MB group particularly in patients with no coronary atherosclerosis (5.3 Vs 4.5, p = 0.04). Tp-e and TDR values were decreased in MB in comparison to non-MB patients particularly in patients with coronary atherosclerosis (69 Vs 80, p = 0.003 and 0.18 Vs 0.2, p = 0.01 respectively). Isolated T inversion in V1 was observed more in MB compared to non-MB patients (58% Vs 5%, p ≤ 0.0001) particularly in patients without coronary atherosclerosis.

Conclusion: MB patients have shown decreased Tp-e and TDR markers particularly in MB patients with coronary atherosclerosis.

Keywords: Arrhythmia; CT angiography; Coronary atherosclerosis; ECG; Myocardial bridge.