Background: Chronic Obstructive Pulmonary Disease (COPD) which is characterized by persistent airflow restriction and respiratory symptoms. Studies demonstrated that cardiac arrhythmias, cardiovascular mortality and cardiac death increased in these patients due to altered myocardial repolarization. Frontal QRS-T angle is a novel marker of myocardial depolarization and repolarization heterogeneity. In this study, we aimed to investigate the relationship between frontal QRS-T angle and COPD severity in patients with newly diagnosed COPD. Methods: A total of 104 newly diagnosed COPD patients without any significant comorbidities were included in this study. Patients were divided into two groups according to GOLD stage as follows: patients with mild and moderate COPD (group I) and severe and very severe COPD (group II). Frontal QRS-T angle was calculated from the automatic report of the electrocardiography device . Results: Frontal QRS-T angle was significantly higher in group II patients compared to in group I patients (43.0 [25.5-60.0] vs. 20.0 [12.0-32.0], P < 0.001). The best cut-off value of frontal QRS-T angle for predicting severe-very severe COPD was ≥ 34.5°. Correlation analysis showed that frontal QRS-T angle was negatively correlated with FEV1/FVC (r = –0.524, P < 0.001) and MEF25-75 (r = –0.453, P < 0.001). In linear regression analysis, It was found that MEF25-75 (β: –0.593, P = 0.006) was the only independent predictor of the frontal QRS-T angle. Conclusions: Frontal QRS-T angle, an easily obtainable marker form surface electrocardiography. In this study, we have shown for the first time that frontal QRS-T angle was significantly increased in patients with severe and very severe COPD.

Abstract Aim: The prevalence of atrial fibrillation (AF) in patients with myocardial infarction (MI) ranges widely and has been reported to be as high as 21%. However, the demographic, clinical, and angiographic characteristics of AF patients with de novo MI is unclear. The aim of this study was to investigate the prevalence of patients presenting with de novo MI with AF. Methods: The study was performed as a sub-study of the MINOCA-TR (Myocardial Infarction with Non-obstructive Coronary Arteries in Turkish Population) Registry, a multicenter, cross-sectional, observational, all-comer registry. MI patients without a known history of stable coronary artery disease and/or prior coronary revascularization were enrolled in the study. Patients were divided into AF and Non-AF groups according to their presenting cardiac rhythm. Results: A total of 1793 patients were screened and 1626 were included in the study. Mean age was 61.5 (12.5) years. 70.7% of patients were men. Prevalence of AF was 3.1% (51 patients). AF patients were older [73.4 (9.4) vs. 61.0 (12.4) years, p<0.001] than non-AF patients. The proportion of women to men in the AF group was also higher than in the non-AF group (43.1% vs. 28.7%, p=0.027). Dramatically, the minority of patients were previously diagnosed with AF (14 patients, 27.4%) and only 1 out of every 5 AF patients (10 patients, 19.6%) was using oral anticoagulants (OAC). Conclusions: AF prevalence in patients presenting with de novo MI was lower than reported in previous studies. The majority of AF patients did not have any knowledge of their arrhythmia and were not undergoing OAC therapy at admission, emphasizing the vital role of successful diagnostic strategies, patient education, and implementations for guideline adaptation.