Association between T wave morphology parameters and abnormal cardiac SPECT imaging

Background

T-wave morphology dispersion (TMD) described the electrocardiographic T-wave heterogeneity during a single cardiac cycle. Total cosine R-to-T (TCRT) is the average of the cosines of the angles between the QRS and T vectors on the ECG. We examine the predictive value of TMD and TCRT calculation to assess abnormal myocardial perfusion.
Methods

Retrospective single center cohort study including all patients referred for evaluation of ischemia by myocardial SPECT scanning with no known history of ischemic heart disease, from 1 January 2019 to 31 December 2019. Study endpoint was the correlation between the calculated TMD and TCRT values and detection of myocardial injury or ischemia by myocardial SPECT.

Results

Among 606 patients, calculated TCRT was 0.401±0.53 for the normal group and 0.283±0.62 for the abnormal group (p=0.007). Measured TMD was 22.9±16.6 degrees (p<0.001) in the normal group, compared to 31.5±22.8 degrees (p<0.001) for the abnormal group.

Conclusions

The results demonstrate a correlation between the decreased TCRT values and increase TMD and myocardial ischemia seen in SPECT results. The TCRT and TMD can be used as simple and non-invasive markers to predict abnormal SPECT results and ischemic heart disease in patients with no known cardiac history.