title: Predictive value of electrocardiographic T-wave morphology parameters and T-wave peak to T-wave end interval for sudden cardiac death in the general population.
abstract: BACKGROUND
  Previous population studies have found an association between electrocardiographic T-wave morphology parameters and cardiovascular mortality, but their relationship to sudden cardiac death (SCD) is not clear. To our knowledge, there are no follow-up studies assessing the association between electrocardiographic T-wave peak to T-wave end interval (TPE) and SCD. We assessed the predictive value of electrocardiographic T-wave morphology parameters and TPE for SCD in an adult general population sample.
  
  
  RESULTS
  A total of 4 T-wave morphology parameters (principal component analysis ratio, T-wave morphology dispersion, total cosine R-to-T, T-wave residuum) as well as TPE were measured from digital standard 12-lead ECGs in 5618 adults (46% men; mean age 50.9±12.5 years) participating in the Finnish population-based Health 2000 Study. After a mean follow-up time of 7.7±1.4 years, 72 SCDs had occurred. In univariable analyses, all T-wave morphology parameters were associated with an increased SCD risk. In multivariable Cox models, T-wave morphology dispersion and total cosine R-to-T remained as predictors of SCD, with T-wave morphology dispersion showing the highest SCD risk (hazard ratio of 1.4 [95% confidence interval 1.1-1.7, P=0.001] per 1 SD increase in the loge T-wave morphology dispersion). In contrast, TPE was not associated with SCD in univariable or multivariable analyses.
  
  
  CONCLUSIONS
  Electrocardiographic T-wave morphology parameters describing the 3-dimensional shape of the T-wave stratify SCD risk in the general population, but we did not find an association between TPE and SCD.
authors.affiliation: Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, Finland.
authors.forename: Kimmo
authors.initials: K
authors.lastname: Porthan
authors.forename: Matti
authors.initials: M
authors.lastname: Viitasalo
authors.forename: Lauri
authors.initials: L
authors.lastname: Toivonen
authors.forename: Aki S
authors.initials: AS
authors.lastname: Havulinna
authors.forename: Antti
authors.initials: A
authors.lastname: Jula
authors.forename: Jani T
authors.initials: JT
authors.lastname: Tikkanen
authors.forename: Heikki
authors.initials: H
authors.lastname: Väänänen
authors.forename: Markku S
authors.initials: MS
authors.lastname: Nieminen
authors.forename: Heikki V
authors.initials: HV
authors.lastname: Huikuri
authors.forename: Christopher
authors.initials: C
authors.lastname: Newton-Cheh
authors.forename: Veikko
authors.initials: V
authors.lastname: Salomaa
authors.forename: Lasse
authors.initials: L
authors.lastname: Oikarinen
mesh_terms: D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D004562:Electrocardiography; D005260:Female; D005387:Finland / Q000453:epidemiology; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D025341:Principal Component Analysis; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors
keywords: electrocardiography; epidemiology; prognosis; repolarization; sudden death