{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T13:53:53Z","timestamp":1768485233780,"version":"3.49.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2015,7,17]]},"abstract":"\n Background<\/jats:title>\n \n A specific electrocardiographic (\n ECG<\/jats:styled-content>\n ) marker of ischemia would greatly improve the speed and accuracy of detecting and treating non\u2010\n ST<\/jats:styled-content>\n elevation myocardial infarction (\n NSTEMI<\/jats:styled-content>\n ). We hypothesize that ischemia induces ventricular repolarization dispersion (\n VRD<\/jats:styled-content>\n ), altering the T\u2010wave before any\n ST<\/jats:styled-content>\n segment deviation. We sought to evaluate the clinical utility of\n VRD<\/jats:styled-content>\n to (1) detect\n NSTEMI<\/jats:styled-content>\n cases in the emergency department (\n ED<\/jats:styled-content>\n ) and (2) identify\n NSTEMI<\/jats:styled-content>\n cases at high risk for in\u2010hospital major adverse cardiac events (\n MACEs<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We continuously recorded 12\u2010lead Holter\n ECG<\/jats:styled-content>\n s from chest pain patients upon their arrival to the\n ED<\/jats:styled-content>\n .\n VRD<\/jats:styled-content>\n was quantified using principal component analysis of the 12\u2010lead\n ECG<\/jats:styled-content>\n to compute a T\u2010wave complexity ratio (ie, ratio of second to first eigenvectors of repolarization). Clinical outcomes were obtained from hospital records\n .<\/jats:bold>\n The sample was composed mainly of older males (n=369; ages 63\u00b112\u00a0years; 63% males), and 92 (25%) had\n NSTEMI<\/jats:styled-content>\n and 26 (7%) had\n MACEs<\/jats:styled-content>\n . Baseline T\u2010wave complexity ratio modestly correlated with peak troponin levels (\n r<\/jats:italic>\n =0.41;\n P<\/jats:italic>\n <0.001) and was a good classifier of\n NSTEMI<\/jats:styled-content>\n events (area under the curve=0.70). An increased T\u2010wave complexity ratio on the presenting\n ECG<\/jats:styled-content>\n was strongly associated with\n NSTEMI<\/jats:styled-content>\n (odds ratio [\n OR]<\/jats:styled-content>\n =3.8 [2.1 to 5.8]) and in\u2010hospital\n MACE<\/jats:styled-content>\n (\n OR<\/jats:styled-content>\n =8.2 [3.1 to 21.5]).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n A simple measure of global\n VRD<\/jats:styled-content>\n on the presenting 12\u2010lead\n ECG<\/jats:styled-content>\n correlates with ischemic myocardial injury and can discriminate\n NSTEMI<\/jats:styled-content>\n cases very early during evaluation. Prospective studies should validate these findings and test whether\n VRD<\/jats:styled-content>\n can guide therapy.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.115.002057","type":"journal-article","created":{"date-parts":[[2018,9,14]],"date-time":"2018-09-14T19:04:02Z","timestamp":1536951842000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Clinical Utility of Ventricular Repolarization Dispersion for Real\u2010Time Detection of Non\u2010ST Elevation Myocardial Infarction in Emergency Departments"],"prefix":"10.1161","volume":"4","author":[{"given":"Salah S.","family":"Al\u2010Zaiti","sequence":"first","affiliation":[{"name":"School of Nursing, University of Pittsburgh, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clifton W.","family":"Callaway","sequence":"additional","affiliation":[{"name":"Emergency Medicine, University of Pittsburgh, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teri M.","family":"Kozik","sequence":"additional","affiliation":[{"name":"Clinical Research, Dignity Health, St. Joseph Medical Center, Stockton, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary G.","family":"Carey","sequence":"additional","affiliation":[{"name":"Clinical Nursing Research Center, University of Rochester Medical Center, Rochester, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele M.","family":"Pelter","sequence":"additional","affiliation":[{"name":"School of Nursing, University of California San Francisco (UCSF), San Francisco, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000441139.02102.80"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.02.013"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.018"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2013.06.029"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.23.2908"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr236"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2013.04.005"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000065602.78328.B5"},{"key":"e_1_3_3_10_2","article-title":"Ventricular repolarization dispersion during ischemia course measured by temporal and spatial electrocardiographic parameters","author":"Arini PD","year":"2008","unstructured":"Arini PD, Baglivo FH, Martinez JP, Laguna P. 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A research method for detecting transient myocardial ischemia in patients with suspected acute coronary syndrome using continuous ST\u2010segment analysis. 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