Dynamics and Rate‐Dependence of the Spatial Angle between Ventricular Depolarization and Repolarization Wave Fronts during Exercise ECG

Kenttä, Tuomas; Karsikas, Mari; Kiviniemi, Antti M.; Tulppo, Mikko P.; Seppänen, Tapio; Huikuri, Heikki V.

doi:10.1111/j.1542-474x.2010.00374.x

Cited by 14 publications

(11 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the same year, in 2010, Kenttä et al [50] studied the beat-to-beat rate dependency and gender affect on spatial angle (TCRT or QRS-T angle) between QRS-T loops during exercise ECG. They suggested that the beat-to-beat individual patterns of TCRT and QRS/T angle are influenced by heart rate (HR) and gender.…”

Section: Beat-to-beat Vcg-based Parametersmentioning

confidence: 99%

“…The relationship between HR and VCG-based parameters has been investigated by a few studies [50,76,88]. Some of the studies demonstrated that the VCG parameters are dependent on the HR.…”

Section: Heart Rate Dependencymentioning

confidence: 99%

“…Several VCG-based parameters were proposed in last few decades for identifying and characterizing various cardiac patients [3,39,50,58,68,96,97]. A brief description of several VCG-based parameters is given below.…”

Section: Vcg-based Parametersmentioning

confidence: 99%

See 2 more Smart Citations

A review of beat-to-beat vectorcardiographic (VCG) parameters for analyzing repolarization variability in ECG signals

Hasan¹,

Abbott²

2016

Biomedical Engineering / Biomedizinische Technik

View full text Add to dashboard Cite

Elevated ventricular repolarization lability is believed to be linked to the risk of ventricular tachycardia/ventricular fibrillation. However, ventricular repolarization is a complex electrical phenomenon, and abnormalities in ventricular repolarization are not completely understood. To evaluate repolarization lability, vectorcardiography (VCG) is an alternative approach where the electrocardiographic (ECG) signal can be considered as possessing both magnitude and direction. Recent research has shown that VCG is advantageous over ECG signal analysis for identification of repolarization abnormality. One of the key reasons is that the VCG approach does not rely on exact identification of the T-wave offset, which improves the reproducibility of the VCG technique. However, beat-to-beat variability in VCG is an emerging area for the investigation of repolarization abnormality though not yet fully realized. Therefore, the purpose of this review is to explore the techniques, findings, and efficacy of beat-to-beat VCG parameters for analyzing repolarization lability, which may have potential utility for further study.

show abstract

Section: Beat-to-beat Vcg-based Parametersmentioning

confidence: 99%

“…The relationship between HR and VCG-based parameters has been investigated by a few studies [50,76,88]. Some of the studies demonstrated that the VCG parameters are dependent on the HR.…”

Section: Heart Rate Dependencymentioning

confidence: 99%

See 1 more Smart Citation

A review of beat-to-beat vectorcardiographic (VCG) parameters for analyzing repolarization variability in ECG signals

Hasan¹,

Abbott²

2016

Biomedical Engineering / Biomedizinische Technik

View full text Add to dashboard Cite

show abstract

“…41 FQRSTA is a very powerful predictor of cardiovascular events (e.g., myocardial ischemia), 42 sudden cardiac death, [13][14][15][16][17]43 appropriate ICD therapy, 44,45 all-cause mortality, 15,[33][34][35][36][37] increased cardiac-related hospitalizations, 17,35 reduced left ventricular function, [34][35][36]46 especially in patients with postinfarction, [13][14][15][16][17] acute myocardial infarction with LVEF ࣘ40%, 47 the elderly, 12 chronic dialysis, [18][19][20] heart failure with preserved ejection fraction, 17 and ischemic stroke 48 considered stronger than any of the classical cardiovascular risk factors. 16,17 Risk factors leading to an elevation in FQRSTA were related to coronary artery disease, dialysis, poor-controlled hypertension, 49,50 pulmonary arterial hypertension, 51 left/right ventricular hypertrophy, 51-54 dilated left ventricle, 55 lower LVEF, 56 DM, 57, 58 smoking, [57][58][59] and female gender. …”

Section: Dm and Fqrstamentioning

confidence: 99%

“…16,17 Risk factors leading to an elevation in FQRSTA were related to coronary artery disease, dialysis, poor-controlled hypertension, 49,50 pulmonary arterial hypertension, 51 left/right ventricular hypertrophy, 51-54 dilated left ventricle, 55 lower LVEF, 56 DM, 57, 58 smoking, [57][58][59] and female gender. 57,58 Most researches were focused on QRS-T angle derived from planar traditional ECG or spatial vector. The study related to FQRSTA derived from Holter was limited.…”

Section: Dm and Fqrstamentioning

confidence: 99%

Changes of Virtual Planar QRS and T Vectors Derived from Holter in the Populations with and without Diabetes Mellitus

Chen

Lin

et al. 2015

Ann Noninvasive Electrocardiol

View full text Add to dashboard Cite

Aims: Research related to type 2 diabetes mellitus (DM) and parameters of electrocardiography (ECG) was limited. Patients with and without DM (NDM) were randomly enrolled in a study to exploit the influence of DM on planar QRS and T vectors derived from the Virtual Holter process.Methods: A total of 216 (NDM) and 127 DM patients were consecutively and randomly recruited. We selected a 1-minute length of ECG, which was scheduled for analysis at 4 AM. After a series of calculating algorisms, we received the virtual planar vector parameters.Results: Patients with DM were elderly (65.61 ± 12.08 vs 59.41 ± 16.86 years, P < 0.001); higher morbidity of hypertension (76.38% vs 58.14%, P < 0.001) and coronary artery disease (44.09% vs 32.41%, P = 0.03); thicker interventricular septum (10.92 ± 1.77 vs 10.08 ± 1.96 mm, P < 0.001) and left ventricular posterior wall (9.84 ± 1.38 vs 9.39 ± 1.66 mm, P = 0.03); higher lipid levels and average heart rate (66.67 ± 12.04 vs 61.87 ± 13.36 bpm, P < 0.01); higher angle of horizontal QRS vector (HQRSA, -2.87 ± 48.48 vs -19.00 ± 40.18 degrees, P < 0.01); lower maximal magnitude of horizontal T vector (HTV, 2.33 ± 1.47 vs 2.88 ± 1.89 mm, P = 0.01) and maximal magnitude of right side T vector (2.77 ± 1.55 vs 3.27 ± 1.92 mm, P = 0.03), and no difference in angle of frontal QRS-T vector (FQRSTA, 32.77 ± 54.20 vs 28.39 ± 52.87 degrees, P = 0.74) compared with patients having NDM. After adjusting for confounding factors, DM was significantly effective on FQRSTA (regression coefficient -40.0, 95%CI -66.4 to -13.6, P < 0.01), HQRSA (regression coefficient 22.6, 95%CI 2.5 to 42.8, P = 0.03), and HTV (regression coefficient 0.9, 95%CI 0.2 to 1.7, P = 0.01). Confounding

show abstract

Sex differences in cardiac autonomic regulation and in repolarisation electrocardiography

Smetana

Malík

2013

Pflugers Arch - Eur J Physiol

View full text Add to dashboard Cite

The review summarises the present knowledge on the sex differences in cardiac autonomic regulations and in related aspects of electrocardiography with particular attention to myocardial repolarisation. Although some of the sex differences are far from fully established, multitude of observations show consistent differences between women and men. Despite more pronounced parasympathetic cardiac regulation, women have higher resting heart rate and lower baroreflex sensitivity. Of the electrocardiographic phenomena, women have longer QT interval duration, repolarisation sequence more synchronised with the inverse of the depolarisation sequence, and likely increased regional heterogeneity of myocardial repolarisation. Studies investigating the relationship of these sex disparities to hormonal differences led frequently to conflicting results. Although sex hormones seem to play a key role by influencing both autonomic tone and electrophysiological properties at the cellular level, neither the truly relevant hormones nor their detailed actions are known. Physiologic usefulness of the described sex differences is also unknown. The review suggests that new studies are needed to advance the understanding of the physiologic mechanisms responsible for these inequalities between women and men and provides key methodological suggestions that need to be followed in future research.

show abstract

Dynamics and Rate‐Dependence of the Spatial Angle between Ventricular Depolarization and Repolarization Wave Fronts during Exercise ECG

Abstract: The individual patterns of TCRT and QRS/T angle are affected by HR and gender. Delayed rate adaptation creates hysteresis in the TCRT/RR slopes.

Cited by 14 publications

References 27 publications

A review of beat-to-beat vectorcardiographic (VCG) parameters for analyzing repolarization variability in ECG signals

A review of beat-to-beat vectorcardiographic (VCG) parameters for analyzing repolarization variability in ECG signals

Changes of Virtual Planar QRS and T Vectors Derived from Holter in the Populations with and without Diabetes Mellitus

Sex differences in cardiac autonomic regulation and in repolarisation electrocardiography

Contact Info

Product

Resources

About