Electrocardiographic T-wave morphology and risk of mortality
| Autor: | Anders G. Holst, Jørgen K. Kanters, Jonas L. Isaksen, Morten W. Skov, Morten S. Olesen, Claus Graff, Adrian Pietersen, Jonas B. Nielsen, Jonas Ghouse |
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| Rok vydání: | 2021 |
| Předmět: |
QT interval
Male medicine.medical_specialty Population 030204 cardiovascular system & hematology Electrocardiography 03 medical and health sciences 0302 clinical medicine Heart Rate Internal medicine T wave Heart rate Risk of mortality Humans Medicine 030212 general & internal medicine education T-wave morphology education.field_of_study medicine.diagnostic_test business.industry Proportional hazards model Hazard ratio Arrhythmias Cardiac Middle Aged All-cause mortality Prognosis medicine.disease Electrocardiogram Long QT Syndrome Heart failure Cardiovascular death Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Isaksen, J L, Ghouse, J, Graff, C, Olesen, M S, Holst, A G, Pietersen, A, Nielsen, J B, Skov, M W & Kanters, J K 2021, ' Electrocardiographic T-wave morphology and risk of mortality ', International Journal of Cardiology, vol. 328, pp. 199-205 . https://doi.org/10.1016/j.ijcard.2020.12.016 |
| ISSN: | 0167-5273 |
| Popis: | BackgroundElectrocardiographic T-wave morphology is used in drug safety studies as an adjunct to the QT c interval, but few measurements of T-wave morphology can be interpreted in clinical practice. Morphology combination score (MCS) is a combination of T-wave flatness/peakedness, asymmetry, and notching, enabling easy visual assessment of T-wave morphology. We aimed to test the association between T-wave morphology, quantified by MCS, and mortality.MethodsWe included electrocardiograms recorded in 2001–2011 from 342,294 primary care patients. Using Cox regression, we evaluated the association between MCS, cardiovascular death, and all-cause mortality, adjusting for heart rate, QT c, QT-prolonging drugs, diabetes, ischemic heart disease, hypertension, and congestive heart failure.Results270,039 individuals (44% men, median age 55 [inter-quartile range: 42–67 years]) were included and followed for a median of 9.3 years, during which time 13,489 (5.0%) died from cardiovascular causes and 50,481 (18.7%) from any cause. High values of MCS (i.e. asymmetric, flattened, and/or notched T waves) were associated with an adjusted mortality Hazard Ratio of 1.75 (95% CI 1.62–1.89) and 1.61 (1.43–1.92) for women and men, respectively. Low values of MCS (i.e. peaked and symmetric T waves) were associated with a Hazard Ratio of 1.18 (1.08–1.28) and 1.71 (1.48–1.98) for women and men, respectively.ConclusionsIn a large primary care population, we found that T-wave asymmetry, flatness, and notching provided prognostic information on mortality independent of heart rate, QTc, and baseline comorbidities. |
| Databáze: | OpenAIRE |
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