Abnormal spatial QRS-T angle predicts mortality in patients undergoing dobutamine stress echocardiography for suspected coronary artery disease
| Autor: | Jan A. Kors, Stefan P. Nelwan, Abdou Elhendy, Ron T. van Domburg, Jonathan Lipton, Arend F.L. Schinkel, Don Poldermans |
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| Přispěvatelé: | Cardiology, Cardiothoracic Surgery, Medical Informatics, Anesthesiology |
| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Coronary Artery Disease Risk Assessment Coronary artery disease Electrocardiography SDG 3 - Good Health and Well-being Predictive Value of Tests Risk Factors Internal medicine medicine Stress Echocardiography Humans Risk factor Aged medicine.diagnostic_test business.industry Hazard ratio Hemodynamics Spatial QRS-T angle General Medicine Middle Aged medicine.disease Prognosis Logistic Models Heart failure cardiovascular system Cardiology Dobutamine Female Radiology Cardiology and Cardiovascular Medicine business medicine.drug Echocardiography Stress |
| Zdroj: | Coronary Artery Disease, 21(1), 26-32. Lippincott Williams & Wilkins |
| ISSN: | 0954-6928 |
| DOI: | 10.1097/mca.0b013e328332ee32 |
| Popis: | Objective To investigate the association between (cardiac) mortality and spatial QRS-T angle in patients undergoing dobutamine - atropine stress echocardiography (DSE) for evaluation of known or suspected coronary disease. Methods Between 1990 and 2003, 2347 patients underwent DSE for evaluation of coronary disease at the Erasmus Medical Center. Echocardiographic images were analyzed offline using a 16-segment, 5-point scoring model for regional function. Twelve-lead resting ECGs were analyzed and patients were grouped in three categories according to their spatial QRS-T angle: normal (0-105 degrees), borderline (105-135 degrees), and abnormal (135-180 degrees). Results Mean age was 61 +/- 13 years, 66% were male, 32% had hypertension, 26% had hypercholesterolemia, 28% were smokers, and 12% were diabetic. During a mean follow-up of 7 +/- 3.4 years, 26.5% (623) of the patients died; 15.3% (359) died due to a cardiac cause. Abnormal QRS-T angle (135-180 degrees) was present in 21% of the patients. Abnormal QRS-T angle was a predictor of cardiac death [ hazard ratio: 3.2 (2.6-4.1)] and all-cause mortality [hazard ratio: 2.2 (1.8-2.6)]. After multivariate analysis abnormal and borderline QRS-T angle, peak wall motion score, age, male sex, history of diabetes, history of heart failure, smoking, and hypertension were independent predictors of (cardiac) death. Conclusion Abnormal QRS-T angle is an independent predictor of (cardiac) death in patients undergoing DSE. Abnormal QRS-T angle should be considered as a risk factor in stable patients evaluated for coronary disease. Coron Artery Dis 21:26-32 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. |
| Databáze: | OpenAIRE |
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