transmedТрансляционная медицинаTranslational Medicine2311-44952410-5155Almazov National Medical Research Centre, Saint Petersburg, Russia10.18705/2311-4495-2025-12-6-518-526transmed-1084Research ArticleСЕРДЕЧНО-СОСУДИСТЫЕ ЗАБОЛЕВАНИЯCARDIOVASCULAR MEDICINEЭлектрокардиографические маркеры дисперсии желудочковой реполяризацииElectrocardiographic markers of ventricular repolarization dispersionhttps://orcid.org/0000-0002-3421-9452АртееваН. В.ArteyevaN. V.

Наталия Викторовна Артеева, доктор биологических наук, ведущий научный сотрудник

лаборатория физиологии сердца

167982; ул. Первомайская, д. 50; Сыктывкар

Natalia V. Arteyeva, DSc of Biology, Leading Resercher

laboratory of heart physiology

167982; 50 Pervomayskaya str.; Syktyvkar

natalia.arteyeva@gmail.comhttps://orcid.org/0000-0002-9780-1503БерниковаО. Г.BernikovaO. G.

Олеся Геннадьевна Берникова, кандидат медицинских наук, ведущий научный сотрудник

лаборатория физиологии сердца

Сыктывкар

Olesya G. Bernikova, MD, Leading Researcher

laboratory of heart physiology

Syktyvkar

bernikovaog@gmail.comhttps://orcid.org/0000-0003-1779-273XАзаровЯ. Э.AzarovJa. E.

Ян Эрнестович Азаров, доктор биологических наук, доцент, главный научный сотрудник

лаборатория физиологии сердца

Сыктывкар

Jan E. Azarov, DSc of Biology, Associate Professor, Chief Researcher

laboratory of heart physiology

Syktyvkar

j.azarov@gmail.comhttps://orcid.org/0000-0002-0852-631XПармонЕ. В.ParmonE. V.

Елена Валерьевна Пармон, кандидат медицинских наук, доцент

кафедра факультетской терапии с клиникой

Санкт-Петербург

Elena V. Parmon, MD, Associate Professor

Department of Faculty Therapy with the Clinic

St. Petersburg

 

parmon@almazovcentre.ruФедеральное государственное бюджетное учреждение науки «Федеральный исследовательский центр «Коми научный центр Уральского отделения Российской академии наук», Институт физиологииРоссияFederal Research Centre “Komi Science Centre” of the Ural Branch of the Russian Academy of SciencesRussian FederationФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Institution "V.A. Almazov National Medical Research Centre" of the Ministry of Health of the Russian FederationRussian Federation202506032026126518526Copyright © Артеева Н.В., Берникова О.Г., Азаров Я.Э., Пармон Е.В., 20262026Артеева Н.В., Берникова О.Г., Азаров Я.Э., Пармон Е.В.Arteyeva N.V., Bernikova O.G., Azarov J.E., Parmon E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://transmed.almazovcentre.ru/jour/article/view/1084

   Нарушения процесса реполяризации миокарда, приводящие к увеличению дисперсии реполяризации (ДР) в желудочках сердца, сопряжены с развитием жизнеугрожающих желудочковых аритмий. Основным инструментом для оценки электрической функции сердца и диагностики нарушений реполяризации служит электрокардиография (ЭКГ).

   Цель данного обзора — ознакомить читателя с последними достижениями отечественной и мировой фундаментальной науки относительно физиологического и клинического значения ДР и ее отображения на ЭКГ.

   Поиск научной литературы осуществляли в базах e-LIBRARY, КиберЛенинка и Pubmed, используя ключевые слова (дисперсия желудочковой реполяризации, дисперсия интервала QT, интервал Tpe, дисперсия интервала Tpe, отношение Tpe/QT) в разных вариантах написания на русском и английском языках. Анализ результатов экспериментальных и клинических исследований, а также математического моделирования показал, что интервал между пиком и окончанием Т-волны (Tpe) и его производные (относительно новые, еще не нашедшие широкого применения в практической диагностике ЭКГ-индексы — дисперсия интервала Tpe и соотношение Tpe/QT) содержат информацию о величине как глобальной, так и локальной ДР в желудочках сердца и являются доказанными полезными предикторами жизнеугрожающих аритмий, связанных с повышенной гетерогенностью реполяризации, и общей смертности, в то время как дисперсия интервала QT (наиболее «традиционный» индекс ДР) дает наименее точную оценку величины ДР и аритмического риска. Приведены пороговые значения ЭКГ-индексов ДР и данные об их зависимости от пола и возраста. Рассмотрены особенности измерения параметров Т-волны, а также проблемы и перспективы поиска новых аритмогенных ЭКГ-индексов.

   Myocardial repolarization disturbances resulting in an increased value of dispersion of ventricular repolarization (DR) are associated with the development of life-threatening ventricular arrhythmias. The main tool for detection of repolarization disorders is electrocardiography (ECG).

   This review is devoted to the new knowledge regarding the physiological and clinical significance of DR and its ECG-reflection.

   The search for scientific literature was performed using e-LIBRARY, CyberLeninka and Pubmed data bases and the keywords (dispersion of repolarization, QT interval dispersion, Tpe interval, Tpe interval dispersion, Tpe/QT ratio) in different Russian and English spellings. The analysis of experimental, clinical and in silico studies demonstrated that the interval between the peak and the end of T-wave (Tpe) and its derivatives (relatively new ECG-indices, not yet widely used in clinical practice — Tpe interval dispersion and Tpe/QT ratio) provide information of both global and local dispersion of ventricular repolarization, being the proven useful predictors of life-threatening arrhythmias associated with the increased repolarization heterogeneity and the total mortality, while the dispersion of QT interval (the most “traditional” index of DR) is the least accurate measure of DR and arrhythmic risk. The threshold values of the considered ECG-indices of DR are given, and the age- and sex-dependence of them is discussed. The peculiarities of T-wave parameters measuring as well as the problems and the prospects of searching for the new arrhythmogenic ECG-indices are discussed.

глобальная и локальная дисперсия желудочковой реполяризацииЭКГдисперсия интервала QTинтервал Tpeдисперсия интервала TpeTpe/QTаритмогенезglobal and local ventricular repolarization dispersionECGQT dispersionTpeTpe dispersionTpe/QTarrhythmogenesisРабота выполнена в рамках ГЗ «Механизм формирования электрической неоднородности на разных уровнях организации сердца» FUUU-2022-0025 (2022-2026гг, № 1021052404529-3) / FUUU-2022-0025- 1021052404529-3"The work was carried out within the framework of the State Assignment "Mechanism of the formation of electrical heterogeneity at different levels of heart organization" FUUU-2022-0025 (2022-2026, Registration No. 1021052404529-3) / FUUU-2022-0025-1021052404529-3ReferencesМиронов Н. Ю., Голицын С. П. Калиевые каналы клеток проводящей системы сердца и рабочего миокарда: структурно-функциональные особенности, патофизиологическое и клиническое значение. Кардиология. 2013;53(11):66–73. https://elibrary.ru/ROFEZJMironov NY, Golitsyn SP. Potassium channels of the cardiac conduction system and myocardium cells: structural and functional features, pathophysiological and clinical significance. Kardiologiya. 2013;53(11):66–73. (In Russ.) https://elibrary.ru/ROFEZJJohnson EK, Springer SJ, Wang W, et al. Differential expression and remodeling of transient outward potassium currents in human left ventricles. Circ Arrhythm Electrophysiol. 2018;11(1):e005914. doi: 10.1161/CIRCEP.117.005914Johnson EK, Springer SJ, Wang W, et al. Differential expression and remodeling of transient outward potassium currents in human left ventricles. Circ Arrhythm Electrophysiol. 2018;11(1):e005914. doi: 10.1161/CIRCEP.117.005914Osadchii OE. Role of abnormal repolarization in the mechanism of cardiac arrhythmia. Acta Physiol. 2017;220(Suppl 712):1–71. doi: 10.1111/apha.12902Osadchii OE. Role of abnormal repolarization in the mechanism of cardiac arrhythmia. Acta Physiol. 2017;220(Suppl 712):1–71. doi: 10.1111/apha.12902Khokhlova A, Balakina-Vikulova N, Katsnelson L, et al. Transmural cellular heterogeneity in myocardial electromechanics. J Physiol Sci. 2018;68(4):387–413. doi: 10.1007/s12576-017-0541-0Khokhlova A, Balakina-Vikulova N, Katsnelson L, et al. Transmural cellular heterogeneity in myocardial electromechanics. J Physiol Sci. 2018;68(4):387–413. doi: 10.1007/s12576-017-0541-0Жданов А. М., Шестаков В. А., Пономаренко В. Б. Неоднородность процессов реполяризации в прогнозе жизнеопасных желудочковых нарушений ритма сердца у больных с полной атриовентрикулярной блокадой. Вестник аритмологии. 2002;30:12–21. https://elibrary.ru/HSQGTDZhdanov AM, Shestakov VA, Ponomarenko VB. Heterogeneity of repolarization processes in the prognosis of life-threatening ventricular cardiac arrhythmias in patients with complete atrioventricular block. Vestnik aritmologii. 2002;30:12–21. (In Russ.) https://elibrary.ru/HSQGTDBachmann TN, Skov MW, Rasmussen PV, et al. Electrocardiographic tpeak-tend interval and risk of cardiovascular morbidity and mortality: results from the copenhagen ECG study. Heart Rhythm. 2016;13(4):915–924. doi: 10.1016/j.hrthm.2015.12.027Bachmann TN, Skov MW, Rasmussen PV, et al. Electrocardiographic tpeak-tend interval and risk of cardiovascular morbidity and mortality: results from the copenhagen ECG study. Heart Rhythm. 2016;13(4):915–924. doi: 10.1016/j.hrthm.2015.12.027Day CP, McComb JM, Campbell RW. QT dispersion: an indication of arrhythmia risk in patients with long QT intervals. British heart journal. 1990;63(6):342–344. doi: 10.1136/hrt.63.6.342Day CP, McComb JM, Campbell RW. QT dispersion: an indication of arrhythmia risk in patients with long QT intervals. British heart journal. 1990;63(6):342–344. doi: 10.1136/hrt.63.6.342Malik M, Batchvarov VN. Measurement, interpretation, and clinical potential of QT dispersion. J Am Coll Cardiol. 2000;36:1749–66. doi: 10.1016/s0735-1097(00)00962-1Malik M, Batchvarov VN. Measurement, interpretation, and clinical potential of QT dispersion. J Am Coll Cardiol. 2000;36:1749–66. doi: 10.1016/s0735-1097(00)00962-1Rautaharju PM, Surawicz B, Gettes LS, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV: the ST segment, T and U waves, and the QT interval: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol. 2009;53(11):982–991. doi: 10.1161/CIRCULATIONAHA.108.191096Rautaharju PM, Surawicz B, Gettes LS, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV: the ST segment, T and U waves, and the QT interval: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol. 2009;53(11):982–991. doi: 10.1161/CIRCULATIONAHA.108.191096Колоцей Л. В., Снежицкий В. А. Многофакторная модель прогнозирования развития полиморфной желудочковой тахикардии у пациентов с лекарственно-индуцированным удлинением интервала QT при применении антиаритмических препаратов III класса. Вестник аритмологии. 2023;30:49–60. https://elibrary.ru/QCDQUHKolotzei LV, Snezhitsky V. A. Multifactorial model for predicting the development of polymorphic ventricular tachycardia in patients with drug-induced prolongation of the QT interval when using class III antiarrhythmic drugs. Vestnik aritmologii. 2023;30:49–60. (In Russ.) https://elibrary.ru/QCDQUHZabel M, Portnoy S, Franz MR. Electrocardiographic indexes of dispersion of ventricular repolarization: an isolated heart validation study. J Am Coll Cardiol. 1995;25(3):746–52. doi: 10.1016/0735-1097(94)00446-WZabel M, Portnoy S, Franz MR. Electrocardiographic indexes of dispersion of ventricular repolarization: an isolated heart validation study. J Am Coll Cardiol. 1995;25(3):746–52. doi: 10.1016/0735-1097(94)00446-WYan GX, Antzelevitch C. Cellular basis for the normal T wave and the electrocardiographic manifestations of the long-QT syndrome. Circulation. 1998;98(18):1928–1936. doi: 10.1161/01.cir.98.18.1928Yan GX, Antzelevitch C. Cellular basis for the normal T wave and the electrocardiographic manifestations of the long-QT syndrome. Circulation. 1998;98(18):1928–1936. doi: 10.1161/01.cir.98.18.1928Xia Y, Liang Y, Kongstad O, et al. Tpeak-Tend interval as an index of global dispersion of ventricular repolarization: evaluations using monophasic action potential mapping of the epi- and endocardium in swine. J Interv Card Electrophysiol. 2005;14:79–87. doi: 10.1007/s10840-005-4592-4Xia Y, Liang Y, Kongstad O, et al. Tpeak-Tend interval as an index of global dispersion of ventricular repolarization: evaluations using monophasic action potential mapping of the epi- and endocardium in swine. J Interv Card Electrophysiol. 2005;14:79–87. doi: 10.1007/s10840-005-4592-4Opthof T, Janse MJ, Meijborg VM, et al. Dispersion in ventricular repolarization in the human, canine and porcine heart. Prog Biophys Mol Biol. 2016;120(1–3):222–235. doi: 10.1016/j.pbiomolbio.2016.01.007Opthof T, Janse MJ, Meijborg VM, et al. Dispersion in ventricular repolarization in the human, canine and porcine heart. Prog Biophys Mol Biol. 2016;120(1–3):222–235. doi: 10.1016/j.pbiomolbio.2016.01.007Kors JA, Ritsema van Eck HJ, van Herpen G. The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol. 2008;41(6):575–80. doi: 10.1016/j.jelectrocard.2008.07.030Kors JA, Ritsema van Eck HJ, van Herpen G. The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol. 2008;41(6):575–80. doi: 10.1016/j.jelectrocard.2008.07.030Arteyeva NV, Goshka SL, Sedova KA, et al. What does the T(peak)-T(end) interval reflect? An experimental and model study. J Electrocardiol. 2013;46(4):296.e1–8. doi: 10.1016/j.jelectrocard.2013.02.001Arteyeva NV, Goshka SL, Sedova KA, et al. What does the T(peak)-T(end) interval reflect? An experimental and model study. J Electrocardiol. 2013;46(4):296.e1–8. doi: 10.1016/j.jelectrocard.2013.02.001Neumann B, Vink AS, Hermans BJM, et al. Manual vs. automatic assessment of the QT-interval and corrected QT. Europace. 2023;25(9). doi: 10.1093/europace/euad213Neumann B, Vink AS, Hermans BJM, et al. Manual vs. automatic assessment of the QT-interval and corrected QT. Europace. 2023;25(9). doi: 10.1093/europace/euad213Bieganowska K, Sawicka-Parobczyk M, Bieganowski M, et al. Tpeak-tend interval in 12-lead electrocardiogram of healthy children and adolescents Tpeak-tend interval in childhood. Ann Noninvasive Electrocardiol. 2013;18(4):344–351. doi: 10.1111/anec.12035Bieganowska K, Sawicka-Parobczyk M, Bieganowski M, et al. Tpeak-tend interval in 12-lead electrocardiogram of healthy children and adolescents Tpeak-tend interval in childhood. Ann Noninvasive Electrocardiol. 2013;18(4):344–351. doi: 10.1111/anec.12035Braschi A, Abrignani MG, Francavilla VC, et al. Age- and sex-based reference ranges for non-invasive ventricular repolarisation parameters. Int J Clin Pract. 2017;71(5). doi: 10.1111/ijcp.12949Braschi A, Abrignani MG, Francavilla VC, et al. Age- and sex-based reference ranges for non-invasive ventricular repolarisation parameters. Int J Clin Pract. 2017;71(5). doi: 10.1111/ijcp.12949Hnatkova K, Toman O, Šišáková M, et al. Sex and race differences in J-Tend, J-Tpeak, and Tpeak-Tend intervals. Sci Rep. 2019;9(1):19880. doi: 10.1038/s41598-019-56328-8Hnatkova K, Toman O, Šišáková M, et al. Sex and race differences in J-Tend, J-Tpeak, and Tpeak-Tend intervals. Sci Rep. 2019;9(1):19880. doi: 10.1038/s41598-019-56328-8Tse G, Gong M, Li CKH, et al. Tpeak-Tend, Tpeak-Tend/QT ratio and Tpeak-Tend dispersion for risk stratification in Brugada Syndrome : A systematic review and meta-analysis. J Arrhythm. 2018;34(6):587–597. doi: 10.1002/joa3.12118Tse G, Gong M, Li CKH, et al. Tpeak-Tend, Tpeak-Tend/QT ratio and Tpeak-Tend dispersion for risk stratification in Brugada Syndrome : A systematic review and meta-analysis. J Arrhythm. 2018;34(6):587–597. doi: 10.1002/joa3.12118Hanson B, Gill J, Western D, et al. Cyclical modulation of human ventricular repolarization by respiration. Front Physiol. 2012;3:379. doi: 10.3389/fphys.2012.00379Hanson B, Gill J, Western D, et al. Cyclical modulation of human ventricular repolarization by respiration. Front Physiol. 2012;3:379. doi: 10.3389/fphys.2012.00379Inanir M, Sincer I, Erdal E, et al. Evaluation of electrocardiographic ventricular repolarization parameters in extreme obesity. J Electrocardiol. 2019;53:36–39. doi: 10.1016/j.jelectrocard.2018.12.003Inanir M, Sincer I, Erdal E, et al. Evaluation of electrocardiographic ventricular repolarization parameters in extreme obesity. J Electrocardiol. 2019;53:36–39. doi: 10.1016/j.jelectrocard.2018.12.003Tse G, Gong M, Meng L, et al. Meta-analysis of Tpeak-Tend and Tpeak-Tend/QT ratio for risk stratification in congenital long QT syndrome. J Electrocardiol. 2018;51(3):396–401. doi: 10.1016/j.jelectrocard.2018.03.001Tse G, Gong M, Meng L, et al. Meta-analysis of Tpeak-Tend and Tpeak-Tend/QT ratio for risk stratification in congenital long QT syndrome. J Electrocardiol. 2018;51(3):396–401. doi: 10.1016/j.jelectrocard.2018.03.001Tse G, Gong M, Meng L, et al. Predictive value of Tpeak-Tend indices for adverse outcomes in acquired qt prolongation: a meta-analysis. Front Physiol. 2018;9:1226. doi: 10.3389/fphys.2018.01226Tse G, Gong M, Meng L, et al. Predictive value of Tpeak-Tend indices for adverse outcomes in acquired qt prolongation: a meta-analysis. Front Physiol. 2018;9:1226. doi: 10.3389/fphys.2018.01226Zhang H, Kharche S, Holden AV, et al. Repolarisation and vulnerability to re-entry in the human heart with short QT syndrome arising from KCNQ1 mutation-a simulation study. Prog Biophys Mol Biol. 2008;96(1–3):112–131. doi: 10.1016/j.pbiomolbio.2007.07.020Zhang H, Kharche S, Holden AV, et al. Repolarisation and vulnerability to re-entry in the human heart with short QT syndrome arising from KCNQ1 mutation-a simulation study. Prog Biophys Mol Biol. 2008;96(1–3):112–131. doi: 10.1016/j.pbiomolbio.2007.07.020Anttonen O, Junttila MJ, Maury P, et al. Differences in twelve-lead electrocardiogram between symptomatic and asymptomatic subjects with short QT interval. Heart Rhythm. 2009;6(2):267–271. doi: 10.1016/j.hrthm.2008.10.033Anttonen O, Junttila MJ, Maury P, et al. Differences in twelve-lead electrocardiogram between symptomatic and asymptomatic subjects with short QT interval. Heart Rhythm. 2009;6(2):267–271. doi: 10.1016/j.hrthm.2008.10.033Castro Hevia J, Antzelevitch C, Tornés Bárzaga F, et al. Tpeak-Tend and Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome. J Am Coll Cardiol. 2006;47(9):1828–34. doi: 10.1016/j.jacc.2005.12.049Castro Hevia J, Antzelevitch C, Tornés Bárzaga F, et al. Tpeak-Tend and Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome. J Am Coll Cardiol. 2006;47(9):1828–34. doi: 10.1016/j.jacc.2005.12.049Wang X, Zhang L, Gao C, et al. ST-segment elevation and the Tpeak-Tend/QT ratio predict the occurrence of malignant arrhythmia events in patients with vasospastic angina. J Electrocardiol. 2019;53:52–56. doi: 10.1016/j.jelectrocard.2019.01.001Wang X, Zhang L, Gao C, et al. ST-segment elevation and the Tpeak-Tend/QT ratio predict the occurrence of malignant arrhythmia events in patients with vasospastic angina. J Electrocardiol. 2019;53:52–56. doi: 10.1016/j.jelectrocard.2019.01.001Chiotis S, Doundoulakis I, Zgouridou A, et al. Predictors of arrhythmic events in hypertrophic cardiomyopathy patients with an implantable cardioverter defibrillator : a systematic review and meta-analysis. Eur Heart J Qual Care Clin Outcomes. 2025;11(7):1004–1014. doi: 10.1093/ehjqcco/qcaf021Chiotis S, Doundoulakis I, Zgouridou A, et al. Predictors of arrhythmic events in hypertrophic cardiomyopathy patients with an implantable cardioverter defibrillator : a systematic review and meta-analysis. Eur Heart J Qual Care Clin Outcomes. 2025;11(7):1004–1014. doi: 10.1093/ehjqcco/qcaf021Demidova MM, Carlson J, Erlinge D, et al. Tpeak-Tend interval is associated with ventricular fibrillation during reperfusion in ST-elevation myocardial infarction. Int J Cardiol. 2019;280:80–83. doi: 10.1016/j.ijcard.2019.01.008Demidova MM, Carlson J, Erlinge D, et al. Tpeak-Tend interval is associated with ventricular fibrillation during reperfusion in ST-elevation myocardial infarction. Int J Cardiol. 2019;280:80–83. doi: 10.1016/j.ijcard.2019.01.008Koca H, Koç M. What is the Normal Value of Tpe Interval and Corrected Tpe Interval? Acta Medica. 2020;51(4):10–5. doi: 10.32552/2020.ActaMedica.493Koca H, Koç M. What is the Normal Value of Tpe Interval and Corrected Tpe Interval? Acta Medica. 2020;51(4):10–5. doi: 10.32552/2020.ActaMedica.493Tse G, Gong M, Wong WT, et al. The Tpeak-Tend interval as an electrocardiographic risk marker of arrhythmic and mortality outcomes : A systematic review and meta-analysis. Heart Rhythm. 2017;14(8):1131–1137. doi: 10.1016/j.hrthm.2017.05.031Tse G, Gong M, Wong WT, et al. The Tpeak-Tend interval as an electrocardiographic risk marker of arrhythmic and mortality outcomes : A systematic review and meta-analysis. Heart Rhythm. 2017;14(8):1131–1137. doi: 10.1016/j.hrthm.2017.05.031Braun CC, Zink MD, Gozdowsky S, et al. A longer Tpeak-Tend interval is associated with a higher risk of death: a meta-analysis. J Clin Med. 2023;12(3):992. doi: 10.3390/jcm12030992Braun CC, Zink MD, Gozdowsky S, et al. A longer Tpeak-Tend interval is associated with a higher risk of death: a meta-analysis. J Clin Med. 2023;12(3):992. doi: 10.3390/jcm12030992Piccirillo G, Moscucci F, Carnovale M, et al. QT and Tpeak-Tend interval variability: Predictive electrical markers of hospital stay length and mortality in acute decompensated heart failure. Preliminary data. Clin Cardiol. 2022;45(12):1192–1198. doi: 10.1002/clc.23888Piccirillo G, Moscucci F, Carnovale M, et al. QT and Tpeak-Tend interval variability: Predictive electrical markers of hospital stay length and mortality in acute decompensated heart failure. Preliminary data. Clin Cardiol. 2022;45(12):1192–1198. doi: 10.1002/clc.23888MozafaryBazargany M, Samimisedeh P, Gholami N, et al. Diagnostic Indicators of ECG for Coronary Slow Flow Phenomenon; a Systematic Review and Meta-Analysis. Arch Acad Emerg Med. 2024;12(1):e34. doi: 10.22037/aaem.v12i1.2202MozafaryBazargany M, Samimisedeh P, Gholami N, et al. Diagnostic Indicators of ECG for Coronary Slow Flow Phenomenon; a Systematic Review and Meta-Analysis. Arch Acad Emerg Med. 2024;12(1):e34. doi: 10.22037/aaem.v12i1.2202Antzelevitch C, Fish J. Electrical heterogeneity within the ventricular wall. Basic Res Cardiol. 2001;96(6):517–527. doi: 10.1007/s003950170002Antzelevitch C, Fish J. Electrical heterogeneity within the ventricular wall. Basic Res Cardiol. 2001;96(6):517–527. doi: 10.1007/s003950170002Sedova K, Galinyte V, Arteyeva N, et al. Multi-lead vs single-lead Tpeak-Tend interval measurements for prediction of reperfusion ventricular tachyarrhythmias. J Cardiovasc Electrophysiol. 2019;30(10):2090–2097. doi: 10.1111/jce.14105Sedova K, Galinyte V, Arteyeva N, et al. Multi-lead vs single-lead Tpeak-Tend interval measurements for prediction of reperfusion ventricular tachyarrhythmias. J Cardiovasc Electrophysiol. 2019;30(10):2090–2097. doi: 10.1111/jce.14105Arteyeva NV, Azarov JE. ECG markers of local but not global increase in dispersion of ventricular repolarization (simulation study). J Electrocardiol. 2020;60:54–59. doi: 10.1016/j.jelectrocard.2020.03.009Arteyeva NV, Azarov JE. ECG markers of local but not global increase in dispersion of ventricular repolarization (simulation study). J Electrocardiol. 2020;60:54–59. doi: 10.1016/j.jelectrocard.2020.03.009Gupta P, Patel C, Patel H, et al. T(p-e)/QT ratio as an index of arrhythmogenesis. J Electrocardiol. 2008;41(6):567–574. doi: 10.1016/j.jelectrocard.2008.07.016Gupta P, Patel C, Patel H, et al. T(p-e)/QT ratio as an index of arrhythmogenesis. J Electrocardiol. 2008;41(6):567–574. doi: 10.1016/j.jelectrocard.2008.07.016Braschi A, Frasheri A, Lombardo RM, et al. Association between Tpeak-Tend/QT and major adverse cardiovascular events in patients with Takotsubo syndrome. Acta Cardiol. 2021;76(7):732–738. doi: 10.1080/00015385.2020.1776012Braschi A, Frasheri A, Lombardo RM, et al. Association between Tpeak-Tend/QT and major adverse cardiovascular events in patients with Takotsubo syndrome. Acta Cardiol. 2021;76(7):732–738. doi: 10.1080/00015385.2020.1776012Wu YE, Ma L, Hu ZP. Prognostic value of infarct-related-lead Tpeak-Tend/QT ratio in patients with ST-segment elevation myocardial infarction. Heart Vessels. 2022;37(4):539–548. doi: 10.1007/s00380-021-01950-8Wu YE, Ma L, Hu ZP. Prognostic value of infarct-related-lead Tpeak-Tend/QT ratio in patients with ST-segment elevation myocardial infarction. Heart Vessels. 2022;37(4):539–548. doi: 10.1007/s00380-021-01950-8Erdem K, Duman I, Ergün R, et al. The correlation between electrocardiographic parameters and mortality in non-cardiac ICU patients. Eur Rev Med Pharmacol Sci. 2023;27(14):6662–6670. doi: 10.26355/eurrev_202307_33136Erdem K, Duman I, Ergün R, et al. The correlation between electrocardiographic parameters and mortality in non-cardiac ICU patients. Eur Rev Med Pharmacol Sci. 2023;27(14):6662–6670. doi: 10.26355/eurrev_202307_33136Bekler Ö, Kazan SD, Harbalioğlu H, et al. Predictive value of electrocardiographic markers versus echocardiographic and clinical measures for appropriate ICD shocks in heart failure patients. J Clin Med. 2025;14(15):5506. doi: 10.3390/jcm14155506Bekler Ö, Kazan SD, Harbalioğlu H, et al. Predictive value of electrocardiographic markers versus echocardiographic and clinical measures for appropriate ICD shocks in heart failure patients. J Clin Med. 2025;14(15):5506. doi: 10.3390/jcm14155506Arteyeva NV, Azarov JE. Scenarios for increasing, decreasing and stability of Tpe/QT ratio (Simulation Study). International Journal of Biomedicine. 2022;12(4):535–38Arteyeva NV, Azarov JE. Scenarios for increasing, decreasing and stability of Tpe/QT ratio (Simulation Study). International Journal of Biomedicine. 2022;12(4):535–38Malik M, Huikuri H, Lombardi F, et al. Conundrum of the Tpeak-Tend interval. J Cardiovasc Electrophysiol. 2018;29(5):767–770. doi: 10.1111/jce.13474Malik M, Huikuri H, Lombardi F, et al. Conundrum of the Tpeak-Tend interval. J Cardiovasc Electrophysiol. 2018;29(5):767–770. doi: 10.1111/jce.13474Reynard JT, Oshodi OM, Lai JC, et al. Electrocardiographic conduction and repolarization markers associated with sudden cardiac death: moving along the electrocardiography waveform. Minerva Cardioangiol. 2019;67(2):131–144. doi: 10.23736/S0026-4725.18.04775–8.Reynard JT, Oshodi OM, Lai JC, et al. Electrocardiographic conduction and repolarization markers associated with sudden cardiac death: moving along the electrocardiography waveform. Minerva Cardioangiol. 2019;67(2):131–144. doi: 10.23736/S0026-4725.18.04775–8.Truyen TTTT, Uy-Evanado A, Nakamura K, et al. Markers of sudden cardiac death associated with the ventricular-paced 12-lead ECG. Eur Heart J Open. 2025;5(6). doi: 10.1093/ehjopen/oeaf131Truyen TTTT, Uy-Evanado A, Nakamura K, et al. Markers of sudden cardiac death associated with the ventricular-paced 12-lead ECG. Eur Heart J Open. 2025;5(6). doi: 10.1093/ehjopen/oeaf131Ertas L, Gul O, Yildirim R, et al. Evaluation of cardiac electrophysiological balance index in children diagnosed with type 1 diabetes mellitus. Cardiol Young. 2025:1–7. doi: 10.1017/S1047951125000150Ertas L, Gul O, Yildirim R, et al. Evaluation of cardiac electrophysiological balance index in children diagnosed with type 1 diabetes mellitus. Cardiol Young. 2025:1–7. doi: 10.1017/S1047951125000150

The authors declare that there are no conflicts of interest present.