title: T-wave axis deviation is associated with biomarkers of low-grade inflammation. Findings from the MOLI-SANI study.
abstract: T-wave axis deviation (TDev) may help identifying subjects at risk for major cardiac events and mortality, but the pathogenesis of TDev is not well established; in particular, the possible association between TDev and inflammation is unexplored and unknown. We aimed at investigating the association between low-grade inflammation and TDev abnormalities by conducting a cross-sectional analysis on 17,507 subjects apparently free from coronary heart and haematological diseases enrolled in the MOLI-SANI study. TDev was measured from a standard 12-lead resting electrocardiogram. High sensitivity (Hs) C-reactive protein (CRP), leukocyte (WBC) and platelet counts, neutrophil or granulocyte to lymphocyte ratios were used as markers of inflammation. In multivariable model subjects reporting high CRP levels had higher odds of having borderline and abnormal TDev (OR=1.70; 95 %CI: 1.53-1.90 and OR=1.72; 95 %CI: 1.23-2.41, respectively); the association was still significant, although reduced, after controlling for body mass index (OR=1.17; 95 %CI: 1.05-1.32, for borderline and OR=1.46; 95 %CI: 1.03-2.08, for abnormal). Similarly, higher neutrophil or granulocyte to lymphocyte ratios were associated with increased odds of having abnormal TDev. Neither platelet nor leukocyte counts were associated with abnormal TDev. The relationship between CRP with TDev abnormalities was significantly stronger in men, in non- obese or normotensive individuals, and in those without metabolic syndrome. In conclusion, C-reactive protein and some cellular biomarkers of inflammation such as granulocyte or neutrophil to lymphocyte ratios were independently associated with abnormal TDev, especially in subjects at low CVD risk. These results suggest that a low-grade inflammation likely contributes to the pathogenesis of T- wave axis deviation.
authors.forename: Marialaura
authors.initials: M
authors.lastname: Bonaccio
authors.forename: Augusto
authors.initials: A
authors.lastname: Di Castelnuovo
authors.forename: Livia
authors.initials: L
authors.lastname: Rago
authors.forename: Amalia
authors.initials: A
authors.lastname: de Curtis
authors.forename: Deodato
authors.initials: D
authors.lastname: Assanelli
authors.forename: Fabio
authors.initials: F
authors.lastname: Badilini
authors.forename: Martino
authors.initials: M
authors.lastname: Vaglio
authors.forename: Simona
authors.initials: S
authors.lastname: Costanzo
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: Persichillo
authors.forename: Chiara
authors.initials: C
authors.lastname: Cerletti
authors.forename: Maria Benedetta
authors.initials: MB
authors.lastname: Donati
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Gaetano
authors.affiliation: Licia Iacoviello, Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Via dell'Elettronica, 86077 Pozzilli (Isernia), Italy, Tel.: +39 0865929664, Fax:+39 0865927575, E-mail: licia.iacoviello@neuromed.it.
authors.forename: Licia
authors.initials: L
authors.lastname: Iacoviello
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D001772:Blood Cell Count; D002097:C-Reactive Protein / Q000032:analysis*; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004522:Educational Status; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D015228:Hypertriglyceridemia / Q000453:epidemiology; D007249:Inflammation / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008564:Membrane Potentials; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D012907:Smoking / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: T-wave axis deviation; hypertension; low-grade inflammation; metabolic syndrome; obesity