title: T-loop morphology as a marker of cardiac events in the elderly.
abstract: ST-T wave changes of electrocardiographic (ECG) leads have long been recognized as predictors of future cardiac events, but they only imperfectly characterize T-loop morphology. Using vectorcardiographic (VCG) parameters, we investigated the predictive value of T-loop abnormality for fatal and nonfatal cardiac events in a prospective cohort study among 5,815 elderly. Separately, the predictive value of an easily obtainable T-loop parameter, the T axis, was also assessed. Measurements were determined by a computer program, using VCGs reconstructed from the standard 12-lead ECGs. During the 3 to 6 (mean 4) years of follow-up, 166 fatal and 193 nonfatal cardiac events occurred. Subjects with an abnormal T-loop morphology had increased risks for fatal cardiac events (hazard ratio 4.3; 95% CI 3.0-6.4) and nonfatal cardiac events (3.0; 1.9-4.8). Risks associated with an abnormal T axis alone were only slightly lower. Additional adjustment for established cardiovascular risk indicators resulted in lower, but still highly significant risks. Both T-loop and T-axis abnormalities appear to be strong, independent risk indicators of cardiac events in the elderly.
authors.affiliation: Department of Medical Informatics, Erasmus University Medical School, Rotterdam, The Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: Kors
authors.forename: M C
authors.initials: MC
authors.lastname: de Bruyne
authors.forename: A W
authors.initials: AW
authors.lastname: Hoes
authors.forename: G
authors.initials: G
authors.lastname: van Herpen
authors.forename: A
authors.initials: A
authors.lastname: Hofman
authors.forename: J H
authors.initials: JH
authors.lastname: van Bemmel
authors.forename: D E
authors.initials: DE
authors.lastname: Grobbee
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000401:mortality / Q000473:pathology / Q000503:physiopathology*; D016757:Death, Sudden, Cardiac; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000002:abnormalities / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D015996:Survival Rate; D014672:Vectorcardiography