QT-DISPERSION IN 12-LEAD SURFACE ECG AND QT-DYNAMICS IN HOLTER-ECG INPATIENTS WITH CORONARY-ARTERY DISEASE IN CHRONIC POSTINFARCTION STADIUM WITH AND WITHOUT VENTRICULAR TACHYARRHYTHMIAS - CORRELATIONS WITH OTHER RISK-PARAMETERS

QT-dispersion (QTD) in 12-lead surface-EGG and QT-dynamics in Holter-E CG, defined as the time course of the frequency corrected QT-interval (mQTc), were determined in 42 patients with coronary artery disease in chronic postinfarction stadium without ventricular tachyarrhythmias ( CAD/VTA-) and in 24 CAD patients with ventricular tachyarrhythmias (CA D/VTA+). 14 healthy volunteers served as control group (CG). Correlati ons with hemodynamic data (LVEF, severity of CAD) and with other risk- parameters (ventricular late potentials, short-time heart rate variabi lity) were calculated. QTD in CAD/VTA- was significantly higher compar ed to CG (48.4 ms +/- 19.6 vs 31.4 ms +/- 9.8, p < 0.05). There were n o intergroup differences in QT-dynamics. CAD/VTA+ patients showed the highest QTD-values (59.5 ms +/- 31.1, p < 0.05 compared to CG/CAD/VTA- ) and a significantly altered QT-dynamics compared to CG/CAD/VTA- (mQT c: 431.3 ms +/- 38.8 vs 400.8 ms +/- 25.5 vs 406.3 ms +/- 10.6, p < 0. 05). Only parameters of QTD were significantly correlated to severity of CAD (r = +0.41, p < 0.01) and to LVEF (r = 0.43, p < 0.01). We did not find significant correlations between the parameters of QT-dispers ion/QT-dynamics among one another and to the risk-parameters. These re sults indicate that the QT-dispersion in CAD-patients also in chronic postinfarction stadium is elevated and that CAD-patients with VTA are characterized by an altered QT-dynamics. Parameters of both methods ar e independent of other validated risk-parameters. So the measurement o f QT-dispersion and QT-dynamics as markers of inhomogenous repolarizat ion could contribute to an improvement of risk-stratification of CAD-p atients.