title: Electrocardiographic Tpeak-Tend interval and risk of cardiovascular morbidity and mortality: Results from the Copenhagen ECG study.
abstract: BACKGROUND
  The electrocardiographic Tpeak-Tend interval is considered a novel risk marker of cardiac arrhythmias and cardiovascular death; however, results to date have been conflicting.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the association between this interval and the risk of all-cause and cardiovascular mortality, atrial fibrillation, and heart failure, allowing for nonlinear relationships.
  
  
  METHODS
  From primary care, 138,404 individuals were included and categorized into seven groups based on Tpeak-Tend interval. Cox regression models were used to describe the association between these groups and the risk of the selected outcomes.
  
  
  RESULTS
  Compared with the reference groups (104-115 ms for all-cause mortality and 98-103 ms for all other outcomes), individuals with a Tpeak-Tend interval in lead V5 <5th percentile (58-77 ms) had hazard ratios of 1.29 (95% confidence interval [CI] 1.21-1.38, P <.001) for all-cause mortality, 1.31 (95% CI 1.15-1.50, P <.001) for cardiovascular death, 1.18 (95% CI 1.06-1.32, P = .003) for atrial fibrillation, and 1.52 (95% CI 1.33-1.74, P <.001) for heart failure. Individuals with a Tpeak-Tend interval ≥95th percentile (116-140 ms) had hazard ratios of 1.15 (95% CI 1.08-1.23, P <.001) for all-cause mortality, 1.30 (95% CI 1.15-1.47, P <.001) for cardiovascular death, 1.09 (95% CI 0.99-1.22, P = .088) for atrial fibrillation, and 1.28 (95% CI 1.12-1.46, P <.001) for heart failure. Similar results were obtained for leads II and V2.
  
  
  CONCLUSIONS
  We observed U-shaped associations between the Tpeak-Tend interval and risk of all-cause and cardiovascular mortality, atrial fibrillation, and heart failure.
authors.affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark; Laboratory for Molecular Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Troels N
authors.initials: TN
authors.lastname: Bachmann
authors.affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark; Laboratory for Molecular Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Morten W
authors.initials: MW
authors.lastname: Skov
authors.affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark; Laboratory for Molecular Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Peter V
authors.initials: PV
authors.lastname: Rasmussen
authors.affiliation: Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
authors.forename: Claus
authors.initials: C
authors.lastname: Graff
authors.affiliation: Copenhagen General Practitioners' Laboratory, Copenhagen, Denmark.
authors.forename: Adrian
authors.initials: A
authors.lastname: Pietersen
authors.affiliation: Copenhagen General Practitioners' Laboratory, Copenhagen, Denmark.
authors.forename: Bent
authors.initials: B
authors.lastname: Lind
authors.affiliation: Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
authors.forename: Johannes J
authors.initials: JJ
authors.lastname: Struijk
authors.affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark; Laboratory for Molecular Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Morten S
authors.initials: MS
authors.lastname: Olesen
authors.affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark; Laboratory for Molecular Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Stig
authors.initials: S
authors.lastname: Haunsø
authors.affiliation: Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark; Laboratory for Molecular Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jesper H
authors.initials: JH
authors.lastname: Svendsen
authors.affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark; Laboratory for Molecular Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Anders G
authors.initials: AG
authors.lastname: Holst
authors.affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark; Laboratory for Molecular Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan; Department of Human Genetics, University of Michigan, Ann Arbor, Michigan. Electronic address: jonas.bille.nielsen@gmail.com.
authors.forename: Jonas B
authors.initials: JB
authors.lastname: Nielsen
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D003718:Denmark / Q000453:epidemiology; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
keywords: Atrial fibrillation; Death; Electrocardiography; General population; Heart failure; Tpeak–Tend interval