Frontal QRS-T Angle as A Non-invasive Predictor of The Presence of Coronary Slow Flow

Sherif, Abdelsalam; Zein El Abdeen, Shimaa Gamal; Soliman, Sammeh Elsayed Abdullah; Ghareeb, Mohammed Salah

doi:10.21608/zumj.2025.414710.4118

Frontal QRS-T Angle as A Non-invasive Predictor of The Presence of Coronary Slow Flow

Document Type : Original Article

Authors

¹ Professor of Cardiology, Faculty of Medicine, Zagazig University

² Assistant professor of Cardiology, Faculty of Medicine, Zagazig University

³ M.B.B.Ch., Faculty of Medicine, Zagazig University

10.21608/zumj.2025.414710.4118

Abstract

Background: Coronary slow flow (CSF) has been documented in roughly 1–7% of individuals undergoing coronary angiography and is recognized for its potential to be clinically significant. The frontal QRS–T angle [f(QRS–T)] is an easily obtainable electrocardiographic index, that provides an indicator of the heart’s electrical stability. This study explored whether an abnormal f(QRS–T) angle on a standard ECG could serve as a non-invasive indicator of CSF.

Methods: In this cross-sectional investigation, 90 adult patients were scheduled for coronary angiography at Zagazig University Hospital were assessed. Comprehensive clinical, laboratory, and imaging evaluations were performed, and f(QRS–T) angle was assessed. According to corrected TIMI frame count (cTFC) values, participants were classified as having either CSF or normal coronary flow, with CSF defined by a cTFC exceeding 27 frames.

Results: Of the 90 patients studied (45 with CSF and 45 with normal flow), no significant variations emerged as regards demographic, clinical, or laboratory characteristics between both groups. Although the mean f(QRS–T) angle was revealed to be higher among the CSF group, with non-statistically significant variation (72.36° vs. 60°; p = 0.075). Although the QRS–T angle did not prove to be a dependable marker for predicting CSF, patients with several concurrent cardiovascular risk factors demonstrated notably greater angle values.

Conclusion: Although the f(QRS–T) angle on its own is not a consistent indicator of CSF, an increased angle seems to correlate with the accumulation of multiple cardiovascular risk factors.

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