Prediction of cardiovascular death and myocardial infarction by the QRS-T angle and T vector loop morphology after angioplasty in stable angina pectoris: an 8-year follow-up.
Reliable cardiovascular (CV) risk assessment by a noninvasive tool would be of great value for CV event prevention. The present study consists of 187 coronary artery disease patients with 8 years of follow-up. Eight vectorcardiographic parameters characterizing different aspects of ventricular repolarization were analyzed at baseline: (1) the ST-segment (ST-VM), (2) the T vector angles (QRS-T angle, Televation, and Tazimuth), (3) the T vector loop morphology (Tavplan and Teigenvalue), and (4) Tarea and Tpeak-end. Cardiovascular death, myocardial infarction (MI), and repeated revascularization were traced via national registries. There were 16 CV deaths and 19 MIs; 89 patients remained free from CV events and revascularization. Ventricular repolarization parameters independently predicted CV death (widened QRS-T angle) and new MI (increased Tavplan) during follow-up. CV mortality was associated with increased divergence between depolarization and repolarization waves (widened QRS-T angle). Increased Tavplan, presumably reflecting heterogeneous repolarization, predicted future MI, which is a novel finding.
Rubulis
Aigars
A
Department of Cardiology, Karolinska University Hospital, Solna, Stockholm, Sweden. aigars.r@gmail.com
Bergfeldt
Lennart
L
Rydén
Lars
L
Jensen
Jens
J
D000787:Angina Pectoris / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality*; D015897:Comorbidity; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality* / Q000517:prevention & control; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology; D014672:Vectorcardiography / Q000379:methods / Q000706:statistics & numerical data*