Spatial QRS-T angle predicts cardiac death in a clinical population

Yamazaki, Takuya; Froelicher, Victor; Myers, Jonathan; Chun, Sung; Wang, Paul

doi:10.1016/j.hrthm.2004.10.040

Cited by 156 publications

(157 citation statements)

References 20 publications

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“…An abnormal spatial QRS-T angle is a strong and independent predictor of cardiovascular mortality in general populations and in patients with acute ischemic chest pain. [7][8][9][10] Similarly, it has been shown to predict arrhythmic death in patients who have had myocardial infarctions and to predict cardiovascular events in women with suspected myocardial ischemia. 11,12 The calculation of the spatial QRS-T angle requires dedicated software that is not widely available and cannot be derived by visual ECG analysis after acquisition.…”

Section: Clinical Perspective P 3186mentioning

confidence: 99%

Prognostic Value and Temporal Behavior of the Planar QRS-T Angle in Patients With Nonischemic Cardiomyopathy

et al. 2008

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Background-The planar QRS-T angle can be easily obtained from standard 12-lead ECGs, but its predictive ability is not established. We sought to determine the predictive ability of the planar QRS-T angle in patients with nonischemic cardiomyopathy and to assess QRS-T angle behavior over time. Methods and Results-Baseline QRS-T angles from 455 patients in the Defibrillators in Nonischemic CardiomyopathyTreatment Evaluation (DEFINITE) trial were measured. All patients had nonischemic cardiomyopathy, New York Heart Association class I to III heart failure, and nonsustained ventricular tachycardia or frequent ventricular ectopy. The primary end point (a composite of total mortality, appropriate implantable cardioverter-defibrillator shock, or resuscitated cardiac arrest) occurred in 25 of 172 patients (14.5%) with a QRS-T angle Յ90°and in 72 of 283 patients (25.4%) with a QRS-T angle Ͼ90°(hazard ratio, 1.93; 95% confidence interval, 1.23 to 3.05; Pϭ0.002). A QRS-T angle Ͼ90°remained a significant predictor of the primary end point (Pϭ0.039) after adjustment for treatment group, age, gender, QRS duration, left bundle-branch block, left ventricular ejection fraction, New York Heart Association class III, atrial fibrillation, and diabetes mellitus. The secondary end point (total mortality) occurred in 17 of the 172 patients (9.9%) with a QRS-T angle Յ90°and in 49 of the 283 patients (17.3%) with a QRS-T angle Ͼ90°(hazard ratio, 1.79; 95% confidence interval, 1.03 to 3.10; Pϭ0.016). A sample of 152 patients with multiple follow-up ECGs was analyzed to assess temporal QRS-T angle behavior. Changes in the QRS-T angle correlated with changes in left ventricular ejection fraction and QRS duration over time (PϽ0.001). Conclusions-A planar QRS-T angle

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Section: Clinical Perspective P 3186mentioning

confidence: 99%

Prognostic Value and Temporal Behavior of the Planar QRS-T Angle in Patients With Nonischemic Cardiomyopathy

et al. 2008

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“…Standardized computerized ECG criteria as described by the GE 12-lead electrographic analysis program were used for the diagnosis of Q-waves, ST changes, and bundle branch blocks. From these measurements, the Romhilt-Estes criteria for left ventricular hypertrophy (LVH), 12 QRST spatial angles, 13 Cardiac Infarction Injury Scores (CIIS) 14 and Selvester 15 scores were calculated.…”

Section: Ecg Analysismentioning

confidence: 99%

Prognostic value of the computerized ECG in Hispanics

Pérez¹,

Yaw²,

Myers³

et al. 2007

Clinical Cardiology

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SummaryBackground: The prevalence and prognostic values of electrocardiogram (ECG) abnormalities in Hispanics have not been compared to other ethnicities in a large population. Despite a worse cardiovascular risk profile, the prevalence of cardiovascular disease is lower in Hispanics compared to non-Hispanics.Hypothesis: We hypothesized that ECG abnormalities were less common in Hispanics and were not as strongly associated with cardiovascular mortality.Methods: 45,563 ECGs ordered for usual clinical indications in a Veteran's hospital were available for analysis. 1,392 patients who died within one week of the ECG were excluded. Demographic characteristics were recorded and the population was followed for an average of 7.5 years using the California Death Index. The presence of baseline ECG characteristics were recorded and analyzed using the GE/Marquette computerized ECG system. Age, sex and heart rate adjusted Cox hazard ratio analyses were performed.Results: Being Hispanic was associated with lower cardiovascular death, with a hazard ratio (HR) of 0.76

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“…Changes in the advanced ECG variables observed in this study evolve with HD progression. They are also regarded as independent predictors of sudden cardiac death in different subject populations and in different diseases (Piccirillo et al., 2007; Yamazaki et al, 2005). For this reason, the evaluation of these advanced ECG variables might also be a predictor of the risk of cardiac arrhythmia in patients with HD.…”

Section: Discussionmentioning

confidence: 99%

Evidence of cardiac electrical remodeling in patients with Huntington disease

et al. 2018

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ObjectiveAlthough Huntington's disease (HD) is a disease of the central nervous system, HD mortality surveys indicate heart disease as a major cause of death. Cardiac dysfunction in HD might be a primary consequence of peripherally expressed mutant huntingtin or secondary to either a general decline in health or the onset of neurological dysfunction. The aim of the study was to clarify the heart muscle involvement.Materials and MethodsWe measured conventional and advanced resting ECG indices. Thirtyone subjects with a confirmed huntingtin gene mutation and 31 age‐ and gender‐matched controls were included. The HD subjects were divided into four groups based on their Unified Huntington Disease Rating Scale (UHDRS) motor score.ResultsWe detected changes in advanced ECG variables connected with electrical ventricular remodeling (t test, p < 0.01). The increase in the unexplained part of both QT variability and the standard deviation of normal‐to‐normal QT intervals, presumably reflecting beat‐to‐beat changes in repolarization, was most pronounced. Further, both variables correlated with the product of the cytosine–adenine–guanine (CAG) triplets’ repeat length and the subjects’ age (CAP), the former R = 0.423 (p = 0.018) and the latter R = 0.499 (p = 0.004). There was no correlation between the CAP score and any of variables representing autonomic nervous system activity.ConclusionsBoth autonomic nervous system dysfunction and cardiac electrical remodeling are present in patients with HD. The changes in advanced ECG variables observed in the study evolve with HD progression. The increased values of QT unexplained variability may be a marker of temporal inhomogeneity in ventricular repolarization associated with malignant ventricular arrhythmias.

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Spatial QRS-T angle predicts cardiac death in a clinical population

Cited by 156 publications

References 20 publications

Prognostic Value and Temporal Behavior of the Planar QRS-T Angle in Patients With Nonischemic Cardiomyopathy

Prognostic Value and Temporal Behavior of the Planar QRS-T Angle in Patients With Nonischemic Cardiomyopathy

Prognostic value of the computerized ECG in Hispanics

Evidence of cardiac electrical remodeling in patients with Huntington disease

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