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, Pentti M.; Menotti, Alessandro; Blackburn, Henry; Parapid, Biljana; Kirćanski, Bratislav

doi:10.1016/j.jelectrocard.2012.07.006

Cited by 7 publications

(5 citation statements)

References 25 publications

(29 reference statements)

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“…Inverted T waves and minor T‐wave abnormalities have been associated with incident CHD and cardiovascular mortality in many previous population‐based studies (Bakhoya et al., 2014; Greenland et al., 2003; Larsen et al., 2002; Laukkanen et al., 2014; Rautaharju et al., 2012). In the majority of these studies, the location of the T‐wave changes was not specified, and the studies included T‐wave changes in general.…”

Section: Discussionmentioning

confidence: 94%

“…Inverted T waves in the electrocardiogram (ECG) defined by the Minnesota codes 5.1‐3 (Prineas et al, 1982) have been associated with ischemic heart disease events as well as cardiovascular and total mortality in former population‐based studies (Bakhoya et al, 2014; Larsen et al., 2002; Laukkanen et al., 2014; Rautaharju et al, 2012). The pathophysiology and prognostic significance of T‐wave inversion may differ between different anatomical lead groups.…”

Section: Introductionmentioning

confidence: 99%

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The prognostic significance of T‐wave inversion according to ECG lead group during long‐term follow‐up in the general population

Istolahti

Lyytikäinen

Huhtala

et al. 2020

Noninvasive Electrocardiol

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Background Inverted T waves in the electrocardiogram (ECG) have been associated with coronary heart disease (CHD) and mortality. The pathophysiology and prognostic significance of T‐wave inversion may differ between different anatomical lead groups, but scientific data related to this issue is scarce. Methods A representative sample of Finnish subjects (n = 6,354) aged over 30 years underwent a health examination including a 12‐lead ECG in the Health 2000 survey. ECGs with T‐wave inversions were divided into three anatomical lead groups (anterior, lateral, and inferior) and were compared to ECGs with no pathological T‐wave inversions in multivariable‐adjusted Fine–Gray and Cox regression hazard models using CHD and mortality as endpoints. Results The follow‐up for both CHD and mortality lasted approximately fifteen years (median value with interquartile ranges between 14.9 and 15.3). In multivariate‐adjusted models, anterior and lateral (but not inferior) T‐wave inversions associated with increased risk of CHD (HR: 2.37 [95% confidence interval 1.20–4.68] and 1.65 [1.27–2.15], respectively). In multivariable analyses, only lateral T‐wave inversions associated with increased risk of mortality in the entire study population (HR 1.51 [1.26–1.81]) as well as among individuals with no CHD at baseline (HR 1.59 [1.29–1.96]). Conclusions The prognostic information of inverted T waves differs between anatomical lead groups. T‐wave inversion in the anterior and lateral lead groups is independently associated with the risk of CHD, and lateral T‐wave inversion is also associated with increased risk of mortality. Inverted T wave in the inferior lead group proved to be a benign phenomenon.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

The prognostic significance of T‐wave inversion according to ECG lead group during long‐term follow‐up in the general population

Istolahti

Lyytikäinen

Huhtala

et al. 2020

Noninvasive Electrocardiol

View full text Add to dashboard Cite

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“…A report from the Seven Countries Study in a male cohort with no manifest cardiac diseases at baseline evaluated the risk of CHD death for isolated inverted T waves with no other codable ECG abnormalities . The risk of CHD death for inverted T waves was over 3‐fold in 5‐year follow‐up, decreasing with the length of follow‐up but still significant at 40‐year follow‐up.…”

Section: Discussionmentioning

confidence: 99%

“…Some newer reports from general populations have documented increased risk for CHD death for widened spatial angle between mean QRS and ST‐T vectors (Ѳ(QRS|STT)) . ST‐ and T‐wave findings in women with CVD are generally considered as secondary abnormalities of little importance in clinical ECG interpretation, although some studies have associated them with CHD mortality risk, including the risk of sudden cardiac death (SCD). From depolarization‐related ECG abnormalities, QRS duration increase even within its upper normal range has been found to be an independent predictor of CHD death, including SCD …”

Section: Introductionmentioning

confidence: 99%

Electrocardiographic Repolarization‐Related Variables as Predictors of Coronary Heart Disease Death in the Women's Health Initiative Study

Rautaharju

Zhang

Vitolins

et al. 2014

JAHA

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BackgroundWe evaluated 25 repolarization‐related ECG variables for the risk of coronary heart disease (CHD) death in 52 994 postmenopausal women from the Women's Health Initiative study.Methods and ResultsHazard ratios from Cox regression were computed for subgroups of women with and without cardiovascular disease (CVD). During the average follow‐up of 16.9 years, 941 CHD deaths occurred. Based on electrophysiological considerations, 2 sets of ECG variables with low correlations were considered as candidates for independent predictors of CHD death: Set 1, Ѳ(Tp|Tref), the spatial angle between T peak (Tp) and normal T reference (Tref) vectors; Ѳ(Tinit|Tterm), the angle between the initial and terminal T vectors; STJ depression in V6 and rate‐adjusted QTp interval (QTpa); and Set 2, TaVR and TV1 amplitudes, heart rate, and QRS duration. Strong independent predictors with over 2‐fold increased risk for CHD death in women with and without CVD were Ѳ(Tp|Tref) >42° from Set 1 and TaVR amplitude >−100 μV from Set 2. The risk for these CHD death predictors remained significant after multivariable adjustment for demographic/clinical factors. Other significant predictors for CHD death in fully adjusted risk models were Ѳ(Tinit|Tterm) >30°, TV1 >175 μV, and QRS duration >100 ms.ConclusionsѲ(Tp|Tref) angle and TaVR amplitude are associated with CHD mortality in postmenopausal women. The use of these measures to identify high‐risk women for further diagnostic evaluation or more intense preventive intervention warrants further study.Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00000611.

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“…In a study Rautaharju et al . isolated negative T waves were independent predictors of mortality, even in man with no evidence of heart disease.…”

Section: Miscellaneousmentioning

confidence: 99%

The Year of 2012 in Electrocardiology

Stern

2013

Noninvasive Electrocardiol

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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

Cited by 7 publications

References 25 publications

The prognostic significance of T‐wave inversion according to ECG lead group during long‐term follow‐up in the general population

The prognostic significance of T‐wave inversion according to ECG lead group during long‐term follow‐up in the general population

Electrocardiographic Repolarization‐Related Variables as Predictors of Coronary Heart Disease Death in the Women's Health Initiative Study

The Year of 2012 in Electrocardiology

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