Diagnostic and prognostic significance of QRS-T angle
- 作者: Blinova E.1, Sakhnova T.1, Yurasova E.1
-
隶属关系:
- National Medical Research Center for Cardiology
- 期: 卷 92, 编号 9 (2020)
- 页面: 85-93
- 栏目: Reviews
- URL: https://journals.rcsi.science/0040-3660/article/view/46861
- DOI: https://doi.org/10.26442/00403660.2020.09.000752
- ID: 46861
如何引用文章
全文:
详细
The angle between the QRS and T vectors reflects the consistency or inconsistency of the processes of de- and repolarization of the ventricles of the heart and is considered one of the indicators of global electrical heterogeneity of myocardium. In recent years, the prognostic value of the QRS-T angle has been demonstrated in relation to total and cardiovascular mortality, both in the population and in various groups of patients. The mechanisms of this phenomenon are not completely clear. The review analyses studies published over the past five years on the relationship between the QRS-T angle and mortality, as well as coronary heart disease and heart failure. Possible mechanisms for increasing the QRS-T angle are discussed. Data are given on the use of the QRS-T angle in diagnostic and prognostic scales, including in combination with other indicators of global electrical heterogeneity of myocardium.
作者简介
E. Blinova
National Medical Research Center for Cardiology
Email: tamara-sahnova@mail.ru
ORCID iD: 0000-0001-8725-7084
к.м.н., науч. сотр. отд. новых методов диагностики Института клинической кардиологии им. А.Л. Мясникова
俄罗斯联邦, MoscowT. Sakhnova
National Medical Research Center for Cardiology
编辑信件的主要联系方式.
Email: tamara-sahnova@mail.ru
ORCID iD: 0000-0002-5543-7184
к.м.н., ст. науч. сотр. отд. новых методов диагностики, ст. науч. сотр. лаб. ЭКГ Института клинической кардиологии им. А.Л. Мясникова
俄罗斯联邦, MoscowE. Yurasova
National Medical Research Center for Cardiology
Email: tamara-sahnova@mail.ru
ORCID iD: 0000-0002-4640-5578
к.м.н., вед. науч. сотр. научно-экспертного отд.
俄罗斯联邦, Moscow参考
- Kardys I, Kors JA, van der Meer IM, et al. Spatial QRS-T angle predicts cardiac death in a general population. Eur Heart J. 2003;24:1357-64.
- Сахнова Т.А., Блинова Е.В., Юрасова Е.С. Пространственный угол QRS-T и желудочковый градиент: диагностическое и прогностическое значение. Кардиологический вестн. 2017;2:70-5 [Sakhnova TA, Blinova EV, Yurasova ES. The spatial QRS-T angle and ventricular gradient: diagnostic and prognostic value. Kardiologicheskiy vestnik. 2017;2:70-5 (In Russ.)].
- Zhang ZM, Prineas RJ, Case D, et al. Comparison of the prognostic significance of the electrocardiographic QRS/T angles in predicting incident coronary heart disease and total mortality (from the atherosclerosis risk in communities study). Am J Cardiol. 2007;100:844-9. doi: 10.1016/j.amjcard.2007.03.104
- Zhang X, Zhu Q, Zhu L, et al. Spatial/Frontal QRS-T Angle Predicts All-Cause Mortality and Cardiac Mortality: A Meta-Analysis. PLoS One. 2015;10(8):e0136174. doi: 10.1371/journal.pone.0136174
- Kück K, Isaksen JL, Graff C, et al. Spatial QRS-T angle variants for prediction of all-cause mortality. J Electrocardiol. 2018;51(5):768-75. doi: 10.1016/j.jelectrocard.2018.05.011
- Zhang ZM, Rautaharju PM, Prineas RJ, et al. A wide QRS/T angle in bundle branch blocks is associated with increased risk for coronary heart disease and all-cause mortality in the Atherosclerosis Risk in Communities (ARIC) Study. J Electrocardiol. 2015;48(4):672-7. doi: 10.1016/j.jelectrocard.2015.04.014
- Lingman M, Hartford M, Karlsson T, et al. Value of the QRS-T area angle in improving the prediction of sudden cardiac death after acute coronary syndromes. Int J Cardiol. 2016;218:1-11. doi: 10.1016/j.ijcard.2016.05.005
- Tereshchenko LG, Kim ED, Oehler A, et al. Electrophysiologic Substrate and Risk of Mortality in Incident Hemodialysis. J Am Soc Nephrol. 2016;27(11):3413-20. doi: 10.1681/ASN.2015080916
- Gleeson S, Liao YW, Dugo C, et al. ECG-derived spatial QRS-T angle is associated with ICD implantation, mortality and heart failure admissions in patients with LV systolic dysfunction. PLoS One. 2017;12(3):e0171069. doi: 10.1371/journal.pone.0171069
- Lipponen JA, Kurl S, Laukkanen JA. Global electrical heterogeneity as a predictor of cardiovascular mortality in men and women. Europace. 2018;20(11):1841-8. doi: 10.1093/europace/euy113
- Skampardoni S, Green D, Hnatkova K, et al. QRS-T Angle Predicts Cardiac Risk and Correlates With Global Longitudinal Strain in Prevalent Hemodialysis Patients. Front Physiol. 2019;10:145. doi: 10.3389/fphys.2019.00145
- Li SN, Zhang XL, Cai GL, et al. Prognostic Significance of Frontal QRS-T Angle in Patients with Idiopathic Dilated Cardiomyopathy. Chin Med J (Engl). 2016;129(16):1904-11. doi: 10.4103/0366-6999.187844
- Chua KC, Teodorescu C, Reinier K, et al. Wide QRS-T Angle on the 12-Lead ECG as a Predictor of Sudden Death Beyond the LV Ejection Fraction. J Cardiovasc Electrophysiol. 2016;27(7):833-9. doi: 10.1111/jce.12989
- May O, Graversen CB, Johansen MØ, Arildsen H. A large frontal QRS-T angle is a strong predictor of the long-term risk of myocardial infarction and all-cause mortality in the diabetic population. J Diabetes Complications. 2017;31(3):551-5. doi: 10.1016/j.jdiacomp.2016.12.001
- Gotsman I, Shauer A, Elizur Y, et al. Temporal changes in electrocardiographic frontal QRS-T angle and survival in patients with heart failure. PLoS One. 2018;13(3):e0194520. doi: 10.1371/journal.pone.0194520
- Colluoglu T, Tanriverdi Z, Unal B, et al. The role of baseline and post-procedural frontal plane QRS-T angles for cardiac risk assessment in patients with acute STEMI. Ann Noninvasive Electrocardiol. 2018;23(5):e12558. doi: 10.1111/anec.12558
- May O, Graversen CB, Johansen MØ, Arildsen H. The prognostic value of the frontal QRS-T angle is comparable to cardiovascular autonomic neuropathy regarding long-term mortality in people with diabetes. A population based study. Diabetes Res Clin Pract. 2018;142:264-8. doi: 10.1016/j.diabres.2018.05.018
- Lazzeroni D, Bini M, Camaiora U, et al. Prognostic value of frontal QRS-T angle in patients undergoing myocardial revascularization or cardiac valve surgery. J Electrocardiol. 2018;51(6):967-72. doi: 10.1016/j.jelectrocard.2018.08.028
- Strebel I, Twerenbold R, Wussler D, et al. Incremental diagnostic and prognostic value of the QRS-T angle, a 12-lead ECG marker quantifying heterogeneity of depolarization and repolarization, in patients with suspected non-ST-elevation myocardial infarction. Int J Cardiol. 2019;277:8-15. doi: 10.1016/j.ijcard.2018.09.040
- Kahraman S, Yilmaz E, Demir AR, et al. The prognostic value of frontal QRS-T angle in patients undergoing transcatheter aortic valve implantation. J Electrocardiol. 2019;55:97-101. doi: 10.1016/j.jelectrocard.2019.05.003
- Terho HK, Tikkanen JT, Kenttä TV, et al. Electrocardiogram as a predictor of sudden cardiac death in middle-aged subjects without a known cardiac disease. Int J Cardiol Heart Vasc. 2018;20:50-5. doi: 10.1016/j.ijcha.2018.08.002
- Rautaharju PM, Kooperberg C, Larson JC, LaCroix A. Electrocardiographic predictors of incident congestive heart failure and all-cause mortality in postmenopausal women: The Women’s Health Initiative. Circulation. 2006;113:481-9. doi: 10.1161/CIRCULATIONAHA.105.537415
- Chen S, Hoss S, Zeniou V, et al. Electrocardiographic Predictors of Morbidity and Mortality in Patients With Acute Myocarditis: The Importance of QRS-T Angle. J Card Fail. 2018;24(1):3-8. doi: 10.1016/j.cardfail.2017.11.001
- Fischer K, Marggraf M, Stark AW, et al. Association of ECG parameters with late gadolinium enhancement and outcome in patients with clinical suspicion of acute or subacute myocarditis referred for CMR imaging. PLoS One. 2020;15(1):e0227134. doi: 10.1371/journal.pone.0227134
- Jensen JR, Kragholm K, Bødker KW, et al. Association between T-wave discordance and the development of heart failure in left bundle branch block patients: Results from the Copenhagen ECG study. J Electrocardiol. 2019;52:39-45. doi: 10.1016/j.jelectrocard.2018.11.001
- Zhang ZM, Rautaharju PM, Prineas RJ, et al. Electrocardiographic QRS-T angle and the risk of incident silent myocardial infarction in the Atherosclerosis Risk in Communities study. J Electrocardiol. 2017;50(5):661-6. doi: 10.1016/j.jelectrocard.2017.05.001
- Dogan A, Kahraman S. Frontal QRS-T angle predicts coronary atherosclerotic burden in patients with ST segment elevation myocardial infarction. J Electrocardiol. 2019;58:155-9. doi: 10.1016/j.jelectrocard.2019.11.042
- Kahraman S, Kalkan AK, Turkyilmaz AB, et al. Frontal QRS-T angle is related with hemodynamic significance of coronary artery stenosis in patients with single vessel disease. Anatol J Cardiol. 2019;22(4):194-201. doi: 10.14744/AnatolJCardiol.2019.99692
- Cortez D, Graw S, Mestroni L. In Hypertrophic Cardiomyopathy, the Spatial Peaks QRS-T Angle Identifies Those With Sustained Ventricular Arrhythmias. Clin Cardiol. 2016;39(8):459-63. doi: 10.1002/clc.22549
- Jogu HR, O’Neal WT, Broughton ST, et al. Frontal QRS-T Angle and the Risk of Atrial Fibrillation in the Elderly. Ann Noninvasive Electrocardiol. 2017;22(2). doi: 10.1111/anec.12388
- Pirinen J, Putaala J, Aro AL, et al. Resting 12-lead electrocardiogram reveals high-risk sources of cardioembolism in young adult ischemic stroke. Int J Cardiol. 2015;198:196-200. doi: 10.1016/j.ijcard.2015.06.095
- Tanriverdi Z, Unal B, Eyuboglu M, et al. The importance of frontal QRS-T angle for predicting non-dipper status in hypertensive patients without left ventricular hypertrophy. Clin Exp Hypertens. 2018;40(4):318-23. doi: 10.1080/10641963.2017.1377214
- Cortez D, Schlegel TT, Ackerman MJ, Bos JM. ECG-derived spatial QRS-T angle is strongly associated with hypertrophic cardiomyopathy. J Electrocardiol. 2017;50(2):195-202. doi: 10.1016/j.jelectrocard.2016.10.001
- Mahinrad S, Ferguson I, Macfarlane PW, et al. Spatial QRS-T Angle and Cognitive Decline in Older Subjects. J Alzheimers Dis. 2019;67(1):279-89. doi: 10.3233/JAD-180633
- Delhey L, Jin J, Thapa S, et al. The association of metabolic syndrome and QRS|T angle in US adults (NHANES III). Ann Noninvasive Electrocardiol. 2020;25(1):e12678. doi: 10.1111/anec.12678
- Dzikowicz DJ, Carey MG. Widened QRS-T Angle May Be a Measure of Poor Ventricular Stretch During Exercise Among On-duty Firefighters. J Cardiovasc Nurs. 2019;34(3):201-7. doi: 10.1097/JCN.0000000000000554
- Thomas JA, Perez-Alday EA, Junell A, et al. Vectorcardiogram in athletes: The Sun Valley Ski Study. Ann Noninvasive Electrocardiol. 2019;24(3):e12614. doi: 10.1111/anec.12614
- Kwon Y, Misialek JR, Duprez D, et al. Sleep-disordered breathing and electrocardiographic QRS-T angle: The MESA study. Ann Noninvasive Electrocardiol. 2018;23(6):e12579. doi: 10.1111/anec.12579
- Gungor M, Celik M, Yalcinkaya E, et al. The Value of Frontal Planar QRS-T Angle in Patients without Angiographically Apparent Atherosclerosis. Med Princ Pract. 2017;26(2):125-31. doi: 10.1159/000453267
- Kurisu S, Nitta K, Sumimoto Y, et al. Frontal QRS-T angle and World Health Organization classification for body mass index. Int J Cardiol. 2018;272:185-8. doi: 10.1016/j.ijcard.2018.08.060
- Chen J, Lin Y, Yu J, et al. Changes of Virtual Planar QRS and T Vectors Derived from Holter in the Populations with and without Diabetes Mellitus. Ann Noninvasive Electrocardiol. 2016;21(1):69-81. doi: 10.1111/anec.12276
- Aro AL, Reinier K, Rusinaru C, et al. Electrical risk score beyond the left ventricular ejection fraction: prediction of sudden cardiac death in the Oregon Sudden Unexpected Death Study and the Atherosclerosis Risk in Communities Study. Eur Heart J. 2017;38(40):3017-25. doi: 10.1093/eurheartj/ehx331
- Perez-Alday EA, Bender A, German D, et al. Dynamic predictive accuracy of electrocardiographic biomarkers of sudden cardiac death within a survival framework: the Atherosclerosis Risk in Communities (ARIC) study. BMC Cardiovasc Disord. 2019;19(1):255. doi: 10.1186/s12872-019-1234-9
- Elffers TW, Trompet S, de Mutsert R, et al. Electrocardiographic Detection of Left Ventricular Hypertrophy; Adding Body Mass Index and Spatial QRS-T Angle: A Cross-Sectional Study. Cardiol Ther. 2019;8(2):345-56. doi: 10.1007/s40119-019-00151-9
- Фролов А.В., Вайханская Т.Г., Мельникова О.П. и др. Индекс электрической нестабильности миокарда: клиническое и прогностическое значение. Рос. кардиологический журн. 2019;24(12):55-61 [Frolov AV, Vaykhanskaya TG, Melnikova OP, et al. Myocardial electrical instability score: clinical and prognostic significance. Rossiyskiy kardiologicheskiy zhurnal. 2019;24(12):55-61 (In Russ.)]. doi: 10.15829/1560-4071-2019-12-55-61
- Tereshchenko LG, Sotoodehnia N, Sitlani CM, et al. Genome-Wide Associations of Global Electrical Heterogeneity ECG Phenotype: The ARIC (Atherosclerosis Risk in Communities) Study and CHS (Cardiovascular Health Study). J Am Heart Assoc. 2018;7(8). pii: e008160. doi: 10.1161/JAHA.117.008160
- Biering-Sørensen T, Kabir M, Waks JW, et al. Global ECG Measures and Cardiac Structure and Function: The ARIC Study (Atherosclerosis Risk in Communities). Circ Arrhythm Electrophysiol. 2018;11(3):e005961. doi: 10.1161/CIRCEP.117.005961