Abstract：Objective To observe if there is significant change in the length of Tpeak-Tend interval(Tpe) in patients with coronary borderline lesion before and after exerciseinduced myocardial ischemia, and to evaluate its predictive value on major adverse cardiovascular events(MACE) among the population with coronary borderline lesion by follow-up. Methods (i) Fifty cases were randomly selected as observation group who were diagnosed with coronary borderline lesion by coronary angiography from January 2014 to January 2015 in our hospital and underwent treadmill exercise test(TET). Fifty healthy people were taken as control group. (ii) The maximal Tpe(Tpe-Max), the average Tpe(Tpe-ave) and Tpe of single lead were measured before and after TET respectively. (iii) Tpe-Max, Tpe-ave and Tpe of single lead before and after TET were compared. (iv) The relationship between the incidence of MACE(cardiac death, acute coronary syndrome or reascularization of target lesions by ischemia and other clinical events) and Tpe was analyzed during an average of one year. Results (i) Tpemax and Tpe-ave in the observation group significantly lengthened after TET(P<0.05). (ii) There was no significant difference in Tpe between the two groups at resting state(P>0.05). (iii) No significant difference of Tpe was found before and after TET in the control group(P>0.05). (iv) Among the 50 cases with coronary borderline lesion, 6 cases suffered acute coronary syndrome, 2 underwent target organ reascularization by ischemia and no cardiac death was reported during a one-year follow-up. The patients with significantly lengthened Tpe were prone to be attacked by MACE while the cases in the control group were not haunted by the above MACE. Conclusion Tpe of patients with coronary borderline lesion significantly lengthens after TET. For the ones with significantly lengthened Tpe, the incidence of MACE increases during one year. However, it still waits for verification that if Tpe can be regarded as an independent predictor for MACE.
[1] Falk E ,Shah PK, Fuster V.Coronary plaque disruption[ J].Circulation, 1995,92（3）: 657-671.[2] Xia Y, Liang Y, Kongstad O, et al. In vivo validation of the coincidence of the peak and end of the T wave with full repolarization of the epicardium and endocardium in swine [J]. Heart Rhythm, 2005,2（2）:162-169.[3] Chinmay P, James FB, Harsh P,et al. Is there a significant transmural gradient in repolarization time in the intact heart? Cellular basis of the T wave: a century of controversy[J]. Circ Arrhythmia Electrophysiol, 2009, 2(1):80-88.[4] Kors JA, Ritsema van Eck HJ, van Herpen G.The meaning of the Tp-Te interval and its diagnostic value[J]. J Electrocardiol, 2008,41（6）:575-580.[5] Korantzopoulos P, Letsas KP, Christogiannis Z, et al.Exercise induced repolarization changes in patients with stable coronary artery disease[J].Am J Cardiol,2011，107(1):37-40.[6] 林晓明，杨希立，刘鹤龄，等. T波峰-末间期与冠状动脉狭窄程度的关系[J].南方医科大学学报，2010，30（8）：572-574.[7] 李国草，王野，夏云龙，等.运动诱发心肌缺血后T波峰-末间期显著增加[J].临床心血管病杂志，2013，29(7)：492-494.[8] Acar GR,Akkoyun M,Nacar AB,et al.Evaluation of Tp-e interval and Tp-e/QT ratio in patients with rheumatoid arthritis[J].Turk Kardiyol Dern Ars,2014,42(1):29-34.[9] Zhao X, Xie Z, Chu Y,et al.Association between Tp-e/QT ratio and prognosis in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction[J]. Clin Cardiol,2012,35(9)：559-564.[10] 陈静，孙国芳，丁颖，等. T波峰-末间期、T波峰-末间期离散度与心肌缺血的关系[J].南昌大学学报：医学版，2015,55(2):38-39.[11] 林晓明，杨希立，刘鹤龄，等.冠心病患者T波峰-末间期的临床意义[J].中国医科大学学报，2014，43（3）：272-274.
2017, Vol. 26 
