Spatial peak and mean QRS-T angles: A comparison of similar but different emerging risk factors for cardiac death
Spatial peak and mean QRS-T angles: A comparison of similar but different emerging risk factors for cardiac death
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DOI：
10.1016/j.jelectrocard.2020.05.013
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发表时间：
2020-07-01
影响因子：
1.3
通讯作者：
Gransberg, Lennart
中科院分区：
文献类型：
--
作者：
Bergfeldt, Lennart;Bergqvist, Gabriel;Gransberg, Lennart
工作背景：空间峰值和平均QRS-T角是心血管事件（包括心源性死亡）的科学而非临床确定的风险因素。本研究的目的是比较这些角度，评估其与高血压（HT）和糖尿病（DM）的关系，并探讨平均QRS-T角与心室梯度之间的关系（VG;反映电不均匀性），这两者都是从QRS面积和Tarea矢量导出的。共1094人参加纳入了来自基于人群的Swedish CardioPulmonary bioImage研究的试点研究的550名50 - 65岁的女性，并将其分为5个亚组：明显健康n = 320; HT n = 311; DM n = 33; DM + HT n = 53;其他疾病n = 377。结果：QRS-T峰角普遍窄于平均QRS-T角，且女性窄于男性。在73名参与者（6.7%）中发现异常峰值（> 124度）和/或平均值（> 119度）QRS-T角。关于异常与正常边界QRS-T角的一致性良好（Cohen's kappa 0.61）。糖尿病患者角异常的发生率为21.2%，而正常人为2.5%。结论：峰值和平均QRS-T角不能互换，而是互补的。糖尿病、高血压、性别和无疾病是两种QRS-T角的重要决定因素。平均QRS-T角与VG关系复杂。所有三个VCG衍生的措施反映了相关的，但不同的电生理特性，并有潜在的预后价值，相对于心血管事件。(C)2020年，任作家。爱思唯尔公司出版
Background: The spatial peak and mean QRS-T angles are scientifically but not clinically established risk factors for cardiovascular events including cardiac death. The study aims were to compare these angles, assess their association-with hypertension (HT) and diabetes mellitus (DM), and explore the relation between the mean QRS-T angle and the ventricular gradient (VG; reflecting electrical heterogeneity), which both are derived from the QRSarea and Tarea vectors.Methods: Altogether 1094 participants (aged 50-65 years, 550 women) from the pilot of the population-based Swedish CArdioPulmonary bioImage Study with Frank vectorcardiographic recordings were included and divided into 5 subgroups: apparently healthy n = 320; HT n = 311; DM n = 33; DM + HT n = 53; miscellaneous conditions n = 377. Abnormal peak and mean QRS-T angles were defined as >95th percentile.Results: Peak QRS-T angles were generally narrower than the mean QRS-T angles; both were narrower in women than in men. Abnormal peak (>124 degrees) and/or mean (>119 degrees) QRS-T angles were found in 73 participants (6.7%). The concordance regarding abnormal versus normal-borderline QRS-T angles was good (Cohen's kappa 0.61). The prevalence of abnormal angles varied from 2.5% in healthy to 21.2% in DM. There was an inverse logarithmical relation between the mean QRS-T angle and the VG.Conclusions: The peak and mean QRS-T angles are not interchangeable but complementary. DM, HT, sex and absence of disease are important determinants of both QRS-T angles. The mean QRS-T angle and the VG relationship is complex. All three VCG derived measures reflect related but differing electrophysiological properties and have potential prognostic value vis-a-vis cardiovascular events. (C) 2020 The Authors. Published by Elsevier Inc.