Spatial QRS-T angle predicts cardiac death in a general population
Spatial QRS-T angle predicts cardiac death in a general population
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DOI：
10.1016/s0195-668x(03)00203-3
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发表时间：
2003-07-01
影响因子：
39.3
通讯作者：
Witteman, JCM
中科院分区：
文献类型：
--
作者：
Kardys, I;Kors, JA;Witteman, JCM
目的 本研究的目的是评估空间 QRS-T 角对于致命性和非致命性心脏事件的预后重要性。 方法和结果 根据鹿特丹前瞻性研究，记录了 6134 名 55 岁及以上男性和女性的心电图 (ECG)。空间 QRS-T 角分为正常、临界或异常。使用Cox比例风险模型，异常角度显示心源性死亡（年龄和性别调整后的风险比5.2（95% Cl 4.0-6.8））、非致命性心脏事件（2.2（1.5-3.1））、猝死（5.6（3.7-8.5））和总死亡率（2.3（2.0-2.7））的风险比增加。经典的心血管和心电图预测因子都没有提供更大的风险比。对这些预测因素进行调整后，异常空间 QRS-T 角与所有致命性研究终点的关联仍然很强，但与非致命性心脏事件的关联消失了。赤池信息准则的计算表明，角度对所有预测都有显着贡献。经典心血管和心电图预测因子的致命终点。 结论 空间 QRS-T 角是老年人心脏死亡率的强有力且独立的预测因子。它比任何经典的心血管危险因素和心电图风险指标都更强，并为它们预测致命的心脏事件提供了额外的价值。 (C) 2003 年由 Elsevier Ltd 代表欧洲心脏病学会出版。
Aims The aim of this study was to assess the prognostic importance of the spatial QRS-T angle for fatal and non-fatal cardiac events.Methods and results Electrocardiograms (ECGs) were recorded in 6134 men and women aged 55 years and over from the prospective population-based Rotterdam Study. Spatial QRS-T angles were categorized as normal, borderline or abnormal. Using Cox's proportional hazards model, abnormal angles showed increased hazard ratios of cardiac death (age-and sex-adjusted hazard ratio 5.2 (95% Cl 4.0-6.8)), non-fatal cardiac events (2.2 (1.5-3.1)), sudden death (5.6 (3.7-8.5)) and total mortality (2.3 (2.0-2.7)). None of the classical cardiovascular and ECG predictors provided larger hazard ratios. After adjustment for these predictors, the association of abnormal spatial QRS-T angles with all fatal study endpoints remained strong, but the association with non-fatal cardiac events disappeared. Computation of Akaike's information criterion showed that the angle contributed significantly to the prediction of all. fatal endpoints by classical cardiovascular and ECG predictors.Conclusion The spatial QRS-T angle is a strong and independent predictor of cardiac mortality in the elderly. It is stronger than any of the classical cardiovascular risk factors and ECG risk indicators and provides additional value to them in predicting fatal cardiac events. (C) 2003 Published by Elsevier Ltd on behalf of The European Society of Cardiology.