Findings relevant to the QRS wave in the resting electrocardiogram are associated with circulating concentrations of high-sensitivity cardiac troponin I in the general population

Abstract

Myocardial damage could develop asymptomatically through nonischemic mechanisms such as cardiac overload. This study investigated possible associations between electrocardiogram (ECG) findings relevant to the QRS wave and high-sensitivity cardiac troponin I (hs-cTnI) in the general population. Subjects undergoing their annual health checkup were enrolled in the study (n = 1258). ECG features relevant to the QRS wave that were investigated included PQ interval, QRS voltage (Sokolow–Lyon voltage), QRS duration, product of QRS duration and voltage (Cornell product), corrected QT interval, and QRS axis. Laboratory measurements included hs-cTnI and B-type natriuretic peptide. hs-cTnI was significantly higher in subjects with a long PQ interval, high Sokolow–Lyon voltage, wide QRS duration, increased Cornell product, long corrected QT interval, or left QRS axis deviation. Univariate and multivariate regression analysis showed that Sokolow–Lyon voltage, QRS duration, and Cornell product were significantly associated with hs-cTnI after adjustment for possible confounding factors, including B-type natriuretic peptide. Logistic regression analysis with the endpoint of higher hs-cTnI than the median value showed that Sokolow–Lyon voltage and Cornell product were independently associated with increased hs-cTnI concentrations. ECG findings relevant to the QRS wave, especially increased QRS voltage, are associated with hs-cTnI in the general population.