Frontal Plane QRS – T Angle Is a Predictor of Ventricular Arrhythmia in Heart Failure With Preserved Ejection Fraction

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology Pub Date : 2025-03-12 DOI:10.1111/anec.70062

Çağrı Zorlu, Barış Açıkel, Sefa Erdi Ömür

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引用次数: 0

Abstract

Introduction

Various ventricular repolarization parameters are known to predict ventricular arrhythmias and mortality in various diseases. Although mortality in patients with heart failure with preserved ejection fraction (HFpEF) is similar to that in heart failure with reduced ejection fraction patients, studies on this subject are more limited. Therefore, it is important to evaluate the relationship between ventricular arrhythmias and mortality and ventricular repolarization parameters, especially the frontal plane QRS–T angle, in patients with HFpEF.

Methods

Electrocardiographic, echocardiographic, and laboratory data of 811 patients were evaluated, and the fQRST angle was calculated on ECG. The occurrence of ventricular tachycardia, ventricular fibrillation, or sudden death within a mean of 48 ± 12 months was recorded. Statistical significance was determined as p < 0.05.

Results

A total of 811 patients were evaluated, 180 patients in the cardiac event group and 631 patients in the no cardiac event group. NT-proBNP, La size, La volume index, Tp-e time, Tp-e/QTc ratio, and fQRS-T angle were statistically significantly higher in the cardiac event group. NT-proBNP level and fQRS-T angle were found to be independent predictors of mortality in multivariate cox analysis. According to ROC analysis, when QRS-T angle has a cut-off value of 58.63, its sensitivity is 81.2, and its specificity is 79.3. Kaplan-Meier analysis also found that when the fQRS-T angle was > 58.63, mortality was higher than at narrower angles.

Conclusions

According to our study, the fQRS-T angle, which can be easily and inexpensively calculated on ECG, predicts long-term ventricular arrhythmias in patients with HFpEF.

Abstract Image

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额平面QRS - T角是保留射血分数的心力衰竭患者室性心律失常的预测因子

各种心室复极参数可以预测各种疾病的室性心律失常和死亡率。尽管保留射血分数（HFpEF）心力衰竭患者的死亡率与降低射血分数心力衰竭患者相似，但这方面的研究更为有限。因此，评价HFpEF患者室性心律失常与死亡率与心室复极参数，尤其是额平面QRS-T角的关系具有重要意义。方法对811例患者的心电图、超声心动图及实验室资料进行分析，计算心电图fQRST角。记录在平均48±12个月内发生室性心动过速、室性颤动或猝死的情况。p <； 0.05为有统计学意义。结果共评估811例患者，其中心脏事件组180例，无心脏事件组631例。心脏事件组NT-proBNP、La大小、La容积指数、Tp-e时间、Tp-e/QTc比值、fQRS-T角均显著增高。多因素cox分析发现NT-proBNP水平和fQRS-T角度是死亡率的独立预测因子。根据ROC分析，当QRS-T角度截断值为58.63时，其敏感性为81.2，特异性为79.3。Kaplan-Meier分析还发现，当fQRS-T角度为58.63时，死亡率高于较窄角度。结论fQRS-T角可预测HFpEF患者的长期室性心律失常，在心电图上计算简便、成本低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Noninvasive Electrocardiology 医学-心血管系统

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation. ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.