The value of the spatial QRS–T angle for assessing the severity of heart damage in patients with arterial hypertension

Sakhnova, T A; Blinova, E V; Saidova, M. A.

doi:10.18087/cardio.2021.11.n1647

Cited by 3 publications

(1 citation statement)

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“…Одним из главных достоинств углов QRS-T называют их высокие прогностические возможности. К настоящему моменту возможности угла QRS-T в различных его формах оценены при ряде нозологий [4,5]. В настоящее время интерес исследователей направлен на изучение не только ассоциации sQRS-Ta и fQRS-Ta с отдельными показателями и факторами риска сердечно-сосудистых заболеваний (ССЗ) [6], но и на их связь с неблагоприятными сердечно-сосудистыми событиями и смертностью как в клинических группах, так и в популяционных исследованиях [7][8][9].…”

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Survival prognosis in individuals with a high spatial QRS-T angle

et al. 2022

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Aim. To evaluate medium-term survival without irreversible and fatal cardiovascular events in individuals with a high spatial QRS-T angle (sQRS-Ta) from a regional Russian sample.Material and methods. We analyzed 1394 electrocardiographic records from a random regional sample of men (30%) and women aged 25-64, which were included in the ESSE-RF1 study. Women were on average 5 years older than men, but there was no difference in mean age in the 45-64 groups. The follow-up period lasted 7 year; 26 irreversible events (cardiovascular death, non-fatal myocardial infarction or stroke) and 63 composite endpoints (CEs) (irreversible event or heart failure progression or revascularization) were identified. Irreversible events and composite endpoint in men were noted more often than in women as follows: 3,7% vs 1,1% (p=0,003) and 6,9% vs 3,6% (p=0,01), respectively. sQRS-Ta was estimated as the angle between the integral QRS and T vectors in the orthogonal leads. Survival was assessed by Kaplan-Meier curves using a log-rank test. Differences were considered significant at p≤0,05. Results. Sex groups did not differ in mean sQRS-Ta. sQRS-Ta ≥90o was considered to be increased. The divergence of survival curves by the end of follow-up period in men with increased sQRS-Ta relative to men with sQRS-Ta <900 was greater than in women as follows: 0,88 vs 0,96 for CE (p=0,0026) and 0,93 vs 0,96 for irreversible events (p=0,009); in women — 0,94 vs 0,98 for CE only (p=0,0016). Initial event and CE in men with increased sQRS-Ta occurred earlier than those with normal sQRS-Ta and then in women with increased sQRS-Ta. There were no differences in the frequency of sQRS-Ta increase among 45-64-year-old men and women, but irreversible events in men with increased sQRS-Ta occurred 5 times more often than in women. According to two-stage logistic regression, the probability of irreversible event in men is 4,35 times higher than in women (p=0,0002). After adjusting for sex, in individuals with increased sQRS-Ta, it is 2,75 times higher than in individuals with sQRS-Ta <90o (p=0,015).Conclusion. In men with increased sQRS-Ta (≥90o), survival without irreversible and fatal cardiovascular events was worse, and life expectancy was shorter than in men with normal sQRS-Ta or women with increased sQRS-Ta. The prognosis of irreversible events was significantly affected by male sex and sQRS-Ta increase.

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Survival prognosis in individuals with a high spatial QRS-T angle

et al. 2022

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Sustainability of spatial QRS-T angle of vectorcardiogram to filtration: a pilot study

Gasanova,

Drozdov,

Kozlovskaya

et al. 2023

Medicinskij alfavit

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Objective: to evaluate sustainability of spatial QRS-T angle of vectorcardiogram to filtration.Materials and methods: Vectorcardiographic records in Frank lead system obtained from 53 randomly included patients with sinus normocardia (28–80 years) were synthesized by means of special algorithm developed in our laboratory based on Bemmel’s matrix. The changes in P, Q, R, S, T amplitudes and in the values of spatial QRS-T angle were analysed at different modes of filtering (70 Гц, 40 Гц, 30 Гц) and without filtering.Results: all of the filtration modes studied diminished the amplitudes of ventricular complex components while no significant changes in the values of spatial QRS-T angle were observed.Conclusion: a new methodology for ECG and VCG parameters sustainability to signal processing (filtration) was developed and tested; the hypothesis about sustainability of spatial QRS-T angle of vectorcardiogram to filtration was approved. Taking into account that spatial QRS-T angle is known as a strong predictor of cardiac diseases, it seems perspective to be implemented in automatic ECG analysis algorythms.

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Associations of the spatial QRS-T angle with clinical, laboratory and echocardiographic parameters in patients with arterial hypertension

Sakhnova

Blinova²,

Yurasova

et al. 2022

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Introduction. The prevalence of arterial hypertension (AH) among the adult population of Russia is high; up to 48% of deaths are due to its complications. Recently, prognostic indicators of the electrocardiogram (ECG) have attracted the attention of researchers. One of them is the QRS-T spatial angle (sQRS-Ta).The aim of the work is to study what clinical, laboratory and echocardiographic parameters are associated with increased sQRS-Ta in patients with AH.Material and methods. The study included 240 AH patients (48% men), mean age 62 ± 11 years. The study did not include patients with valvular disease, bundle branch block, preexcitation and ventricular pacing. Orthogonal leads were synthesized from digital ECGs in 12 leads and sQRS-Ta was calculated as a spatial angle between the integral QRS and T vectors. sQRS-Ta ≥ 90° was considered enlarged. We assessed the associations sQRS-Ta ≥ 90° with the following indicators by the method of logistic regression: sex; the presence of cardiovascular diseases; 5 age groups; overweight, obesity; smoking; heart rate (HR); systolic blood pressure (SBP), diastolic blood pressure; pulse blood pressure; blood glucose; total cholesterol; end-diastolic dimension (EDD) of the left ventricle (LV), LV wall thickness, relative LV wall thickness, left ventricular myocardial mass (LVMM), LVMM/body surface area (BSA); LVMM/height in the degree of 2,7, the presence of LV diastolic dysfunction.Results. According to univariate logistic regression, sQRS-Ta ≥ 90° associations were found with age, SBP, obesity, heart rate, LV EDD, LVMM, LVMM/BSA, and LVMM/ height2,7. In multivariate logistic regression models, the contribution of SBP ≥ 140 mmHg (odds ratio (OR) 2,22, 95% CI 1,20–4,10; p=0.01), age 55–64 years (OR 1,87; 1,01–3,44; p=0 .04), increased LV EDD (OR 2,70; 95% CI 1,27–5,72; p=0.01) and HR (OR 2,27; 95% CI 1,10–6,05; p =0.01) was independent.Conclusions. According to multivariate analysis, independent predictors of an increase in sQRS-Ta in patients with AH were SBP ≥ 140 mm Hg, an increase in LV EDD, HR > 80 beats/min, and age 55–64 years.

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The value of the spatial QRS–T angle for assessing the severity of heart damage in patients with arterial hypertension

Cited by 3 publications

References 18 publications

Survival prognosis in individuals with a high spatial QRS-T angle

Survival prognosis in individuals with a high spatial QRS-T angle

Sustainability of spatial QRS-T angle of vectorcardiogram to filtration: a pilot study

Associations of the spatial QRS-T angle with clinical, laboratory and echocardiographic parameters in patients with arterial hypertension

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