QRS-T angle as a predictor of sudden cardiac death in a middle-aged general population
QRS-T angle as a predictor of sudden cardiac death in a middle-aged general population
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DOI：
10.1093/europace/eur393
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发表时间：
2012-06-01
期刊：
影响因子：
6.1
通讯作者：
Anttonen, Olli
中科院分区：
文献类型：
--
作者：
Aro, Aapo L.;Huikuri, Heikki V.;Anttonen, Olli
从12导联心电图（ECG）测量的空间QRS-T角已被证明可以预测心脏死亡率。然而，有一个缺乏的研究额QRS-T角的预后意义，这是更容易从标准的12导联心电图。本研究的目的是探讨宽额QRS-T角，QRS轴，和T波轴作为心脏病的危险预测在一般population.We评估了12导联心电图的10 957芬兰中年受试者从一般人群记录在1966年和1972年之间，并遵循了30 - 11年的重要性。QRS-T角0 - 90，QRS轴30 - 90，T波轴0 - 90被认为是正常的。主要终点为心律失常死亡，次要终点为全因死亡率和非心源性死亡率。在2.0的受试者中存在QRS-T角<100，并且与猝死风险增加[相对风险（RR）2.26; 95置信区间（CI）1.593.21; P 0.001）和全因死亡率相关（RR 1.57; CI 1.341.84; P 0.001），但非心脏病性死亡率（RR 1.34; CI 0.931.92; P 0.13）。宽QRS-T角的预后意义主要是由于T波轴异常，这预示着心律失常死亡（RR 2.13; CI 1.632.79; P 0.001），全因死亡率（RR 1.39; 1.241.55; P 0.001）和非缺血性心源性死亡（RR 1.87; CI 1.502.34; P <0.001）。额面QRS-T角<100会增加猝死的风险，这主要是T波轴改变的结果。
Spatial QRS-T angle measured from a 12-lead electrocardiogram (ECG) has been shown to predict cardiac mortality. However, there is a paucity of studies on the prognostic significance of frontal QRS-T angle, which is more readily available from the standard 12-lead ECG. The purpose of the present study was to investigate the importance of wide frontal QRS-T angle, QRS-axis, and T-wave axis as cardiac risk predictors in general population.We evaluated the 12-lead ECGs of 10 957 Finnish middle-aged subjects from the general population recorded between 1966 and 1972, and followed them for 30 11 years. QRS-T angle 0 to 90, QRS-axis 30 to 90, and T-wave axis 0 to 90 were considered normal. The primary endpoint was death from arrhythmia, and the secondary endpoints were all-cause mortality and non-arrhythmic cardiac mortality. QRS-T angle epsilon 100 was present in 2.0 of the subjects, and it was associated with an increased risk of sudden arrhythmic death [relative risk (RR) 2.26; 95 confidence interval (CI) 1.593.21; P 0.001) and all-cause mortality (RR 1.57; CI 1.341.84; P 0.001), but not with non-arrhythmic cardiac mortality (RR 1.34; CI 0.931.92; P 0.13). The prognostic significance of wide QRS-T angle was mainly due to abnormal T-wave axis, which predicted death from arrhythmia (RR 2.13; CI 1.632.79; P 0.001), all-cause mortality (RR 1.39; 1.241.55; P 0.001), and non-arrhythmic cardiac death (RR 1.87; CI 1.502.34; P 0.001).Frontal QRS-T angle epsilon 100 increases the risk of arrhythmic death, this being mainly the result of an altered T-wave axis.