T-loop morphology as a marker of cardiac events in the elderly.
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.
Kors
J A
JA
Department of Medical Informatics, Erasmus University Medical School, Rotterdam, The Netherlands.
de Bruyne
M C
MC
Hoes
A W
AW
van Herpen
G
G
Hofman
A
A
van Bemmel
J H
JH
Grobbee
D E
DE
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