Association of Frontal QRS-T Angle–Age Risk Score on Admission Electrocardiogram With Mortality in Patients Admitted With an Acute Coronary Syndrome

Lown, Mark; Munyombwe, Theresa; Harrison, Wendy J.; West, Robert; Hall, Christiana A.; Morrell, Christine; Jackson, B. M.; Sapsford, Robert J; Kilcullen, Niamh; Pepper, Chris; Batin, Phil D.; Hall, Alistair S.; Gale, Chris P

doi:10.1016/j.amjcard.2011.09.014

Cited by 52 publications

(43 citation statements)

References 29 publications

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“…There is limited information about the utility of repolarization subintervals and associated repolarization‐related ECG variables for prediction of adverse cardiac events. However, several investigations have found increased mortality risk in various clinical and general populations for the spatial angle between the mean QRS and T vectors [θ(R m T m )] …”

Section: Introductionmentioning

confidence: 99%

Electrocardiographic Predictors of Coronary Heart Disease and Sudden Cardiac Deaths in Men and Women Free From Cardiovascular Disease in the Atherosclerosis Risk in Communities Study

Rautaharju

Zhang

Warren

et al. 2013

JAHA

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BackgroundWe evaluated predictors of coronary heart disease (CHD) death and sudden cardiac death (SCD) in the Atherosclerosis Risk in Communities (ARIC) study.Methods and ResultsThe study population included 13 621 men and women 45 to 65 years of age free from manifest cardiovascular disease at entry. Hazard ratios from Cox regression with 95% confidence intervals were computed for 18 dichotomized repolarization‐related ECG variables. The average follow‐up was 14 years. Independent predictors of CHD death in men were TaVR‐ and rate‐adjusted QTend (QTea), with a 2‐fold increased risk for both, and spatial angles between mean QRS and T vectors and between Tpeak (Tp) and normal R reference vectors [θ(Rm|Tm) and θ(Tp|Tref), respectively], with a >1.5‐fold increased risk for both. In women, independent predictors of the risk of CHD death were θ(Rm|Tm), with a 2‐fold increased risk for θ(Rm|Tm), and θ(Tp|Tref), with a 1.7‐fold increased risk. Independent predictors of SCD in men were θ(Tp|Tref) and QTea, with a 2‐fold increased risk, and θ(Tinit|Tterm), with a 1.6‐fold increased risk. In women, θ(Tinit|Tterm) was an independent predictor of SCD, with a >3‐fold increased risk, and θ(Rm|Tm) and TV1 were >2‐fold for both.Conclusionsθ(Rm|Tm) and θ(Tp|Tref), reflecting different aspects of ventricular repolarization, were independent predictors of CHD death and SCD, and TaVR and TV1 were also independent predictors. The risk levels for independent predictors for both CHD death and SCD were stronger in women than in men, and QTea was a significant predictor in men but not in women.

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Section: Introductionmentioning

confidence: 99%

Electrocardiographic Predictors of Coronary Heart Disease and Sudden Cardiac Deaths in Men and Women Free From Cardiovascular Disease in the Atherosclerosis Risk in Communities Study

Rautaharju

Zhang

Warren

et al. 2013

JAHA

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“…These may include: QRS duration [1–3], QRS-T angle [4, 5], corrected QT interval [6], QTc dispersion [7, 8], and heart rate variability [9]. The QT interval represents the time from the onset of ventricular depolarization to the end of repolarization.…”

Section: Introductionmentioning

confidence: 99%

Association of corrected QT interval with long-term mortality in patients with syncope

Balasubramaniyam¹,

Palaniswamy²,

Aronow³

et al. 2013

aoms

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IntroductionThe electrocardiographic parameters QRS duration, QRS-T angle and QTc can predict mortality in patients with cardiovascular disease. The prgnostic value of these parameters in hospitalized patients with syncope needs investigation.Material and methodsWe retrospectively studied 590 consecutive patients hospitalized with syncope. After excluding patients with baseline abnormal rhythm, QT- prolonging medications, and missing data, 459 patients were analyzed. Baseline demographic characteristics, co-morbidities, medication use, San Francisco Syncope Rule (SFSR) and Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) score and data on mortality were collected. The categorical variables and continuous variables of the 2 groups of patients with prolonged QTc and normal QTc interval were analyzed by Fischer's exact test and Mann-Whitney Test. A stepwise Cox regression model was used for time to death analysis.ResultsOf 459 patients, prolonged QTc interval was observed in 122 (27%). Mean follow-up was 41 months. Patients with prolonged QTc interval had higher prevalence of cardiovascular disease, OESIL score, high risk SFSR, hypertension, dyslipidemia, coronary artery disease, congestive heart failure, and increased mortality. Stepwise Cox regression analysis showed that significant independent prognostic factors for time to death were prolonged QTc interval (p = 0.005), age (p = 0.001), diabetes mellitus (p = 0.001) and history of malignancy (p = 0.006). QRS duration and QRS-T angle were not independent predictors of mortality.ConclusionsA prolonged QTc interval is an independent predictor of long-term mortality in hospitalized patients with syncope.

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“…Several studies have reported θ (QRS|T) mean to be predictive of adverse cardiac events in clinical as well as in community-based populations. [14][15][16][17][18][19] Hypertension is one of the major contributing factors for excess risk of cardiovascular disease as well as CHD mortality. Systolic blood pressure was 12 mm Hg higher in the isolated T-wave inversion group than in the reference group.…”

Section: Discussionmentioning

confidence: 99%

Isolated negative T waves as independent predictors of short-term and long-term coronary heart disease mortality in men free of manifest heart disease in the Seven Countries Study

Rautaharju

Menotti

Blackburn

et al. 2012

Journal of Electrocardiology

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Association of Frontal QRS-T Angle–Age Risk Score on Admission Electrocardiogram With Mortality in Patients Admitted With an Acute Coronary Syndrome

Cited by 52 publications

References 29 publications

Electrocardiographic Predictors of Coronary Heart Disease and Sudden Cardiac Deaths in Men and Women Free From Cardiovascular Disease in the Atherosclerosis Risk in Communities Study

Electrocardiographic Predictors of Coronary Heart Disease and Sudden Cardiac Deaths in Men and Women Free From Cardiovascular Disease in the Atherosclerosis Risk in Communities Study

Association of corrected QT interval with long-term mortality in patients with syncope

Isolated negative T waves as independent predictors of short-term and long-term coronary heart disease mortality in men free of manifest heart disease in the Seven Countries Study

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