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The possibilities of a conventional 12-lead ECG for early diagnosis of myocardial electrical instability in pulmonary TB patients with concomitant diabetes mellitus or hypertension

https://doi.org/10.17021/1992-6499-2025-1-40-52

Abstract

Patients with pulmonary TB are at the highest risk of developing cardiovascular complications, including developing conditions for electrical instability of the heart. Objective. To optimize the detection of electrical instability of the myocardium in pulmonary TB patients with concomitant diabetes mellitus or hypertension during TB treatment. Materials and methods. We studied 78 pulmonary TB patients, including 31 patients with concomitant diabetes mellitus and 16 patients with concomitant hypertension. We recorded a 12-lead ECG. We performed ECG analysis, T axonometric, and evaluation of the spatial and frontal angles of QRS-Т. The results were processed using statistical software package MS EXCEL 2016 for Windows and STATISTICA 10. Research results. The highest values of the heart rate were in patients with sQRS-Т ≥ 90º, p < 0.05. In pulmonary TB patients with the normal spatial QRS angle the fQRS-T median had a positive value, while in patients with sQRS-Т ≥ 90º it had a negative value, p < 0,05. The sQRS-Т value was higher in pulmonary TB patients over 45 years old or with concomitant diabetes mellitus, p < 0.05. The fQRS-Т value did not depend on TB process spread, diabetes mellitus type, or the stage of hypertension, p > 0.05. The increased sQRS-Т was more frequently detected in men and women with pulmonary TB / diabetes mellitus – 19/31 (61.3 %) cases, and less frequently – in patients with pulmonary TB/hypertension or just TB – 11 / 31 (43.7 %) and 13 / 31 (42 %) cases respectively. Conclusion. Patients with sQRS-T ≥ 90º should be referred to a cardiologist for consultation.

About the Authors

A. I. Nagaev
Central TB Research Institute
Russian Federation

Andrey I. Nagaev, cardiologist

Moscow



E. A. Shergina
Central TB Research Institute
Russian Federation

Elena A. Shergina, Cand. Sci. (Med.), Head of the Department

Moscow



N. L. Karpina
Central TB Research Institute
Russian Federation

Natalia L. Karpina, Dr. Sci. (Med.), Deputy Director

Moscow



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Nagaev A.I., Shergina E.A., Karpina N.L. The possibilities of a conventional 12-lead ECG for early diagnosis of myocardial electrical instability in pulmonary TB patients with concomitant diabetes mellitus or hypertension. Astrakhan medical journal. 2025;20(1):40-52. (In Russ.) https://doi.org/10.17021/1992-6499-2025-1-40-52

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ISSN 1992-6499 (Print)