Clinical value of different QRS-Tangle expressions

J 2018

Clinical value of different QRS-Tangle expressions

HNATKOVA, Katerina, Joachim SEEGERS, Petra BARTHEL, Tomáš NOVOTNÝ, Peter SMETANA et. al.

Basic information

Original name

Clinical value of different QRS-Tangle expressions

Authors

HNATKOVA, Katerina (826 United Kingdom of Great Britain and Northern Ireland), Joachim SEEGERS (276 Germany), Petra BARTHEL (276 Germany), Tomáš NOVOTNÝ (203 Czech Republic, belonging to the institution), Peter SMETANA (40 Austria), Markus ZABEL (276 Germany), Georg SCHMIDT (276 Germany) and Marek MALIK (826 United Kingdom of Great Britain and Northern Ireland, guarantor)

Edition

EP Europace, Oxford, Oxford University Press, 2018, 1099-5129

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 5.047

RIV identification code

RIV/00216224:14110/18:00103545

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1093/europace/eux246

UT WoS

000440944300017

Keywords in English

QRS-T angle; Total cosine R to T; Reproducibility; Mortality risk prediction; Standardization

Abstract

V originále

Aims Increased spatial angle between QRS complex and T wave loop orientations has repeatedly been shown to predict cardiac risk. However, there is no consensus on the methods for the calculation of the angle. This study compared the reproducibility and predictive power of three most common ways of QRS-T angle assessment. Methods and results Electrocardiograms of 352 healthy subjects, 941 survivors of acute myocardial infarction (MI), and 605 patients recorded prior to the implantation of automatic defibrillator [implantable cardioverter defibrillator (ICD)] were used to obtain QRS-T angle measurements by the maximum R to T (MRT), area R to T (ART), and total cosine R to T (TCRT) methods. The results were compared in terms of physiologic reproducibility and power to predict mortality in the cardiac patients during 5-year follow-up. Maximum R to T results were significantly less reproducible compared to the other two methods. Among both survivors of acute MI and ICD recipients, TCRT method was statistically significantly more powerful in predicting mortality during follow-up. Among the acute MI survivors, increased spatial QRS-T angle (TCRT assessment) was particularly powerful in predicting sudden cardiac death with the area under the receiver operator characteristic of 78% (90% confidence interval 63 90%). Among the ICD recipients, TCRT also predicted mortality significantly among patients with prolonged QRS complex duration when the spatial orientation of the QRS complex is poorly defined. Conclusion The TCRT method for the assessment of spatial QRS-T angle appears to offer important advantages in comparison to other methods of measurement. This approach should be included in future clinical studies of the QRS-T angle. The TCRT method might also be a reasonable candidate for the standardization of the QRS-T angle assessment.

Citovat

HNATKOVA, Katerina, Joachim SEEGERS, Petra BARTHEL, Tomáš NOVOTNÝ, Peter SMETANA, Markus ZABEL, Georg SCHMIDT and Marek MALIK. Clinical value of different QRS-Tangle expressions. EP Europace. Oxford: Oxford University Press, 2018, vol. 20, No 8, p. 1352-1361. ISSN 1099-5129. Available from: https://dx.doi.org/10.1093/europace/eux246.

@article{1431036,
   author = {Hnatkova, Katerina and Seegers, Joachim and Barthel, Petra and Novotný, Tomáš and Smetana, Peter and Zabel, Markus and Schmidt, Georg and Malik, Marek},
   article_location = {Oxford},
   article_number = {8},
   doi = {http://dx.doi.org/10.1093/europace/eux246},
   keywords = {QRS-T angle; Total cosine R to T; Reproducibility; Mortality risk prediction; Standardization},
   language = {eng},
   issn = {1099-5129},
   journal = {EP Europace},
   title = {Clinical value of different QRS-Tangle expressions},
   volume = {20},
   year = {2018}
}

TY  - JOUR
ID  - 1431036
AU  - Hnatkova, Katerina - Seegers, Joachim - Barthel, Petra - Novotný, Tomáš - Smetana, Peter - Zabel, Markus - Schmidt, Georg - Malik, Marek
PY  - 2018
TI  - Clinical value of different QRS-Tangle expressions
JF  - EP Europace
VL  - 20
IS  - 8
SP  - 1352-1361
EP  - 1352-1361
PB  - Oxford University Press
SN  - 10995129
KW  - QRS-T angle
KW  - Total cosine R to T
KW  - Reproducibility
KW  - Mortality risk prediction
KW  - Standardization
N2  - Aims Increased spatial angle between QRS complex and T wave loop orientations has repeatedly been shown to predict cardiac risk. However, there is no consensus on the methods for the calculation of the angle. This study compared the reproducibility and predictive power of three most common ways of QRS-T angle assessment. Methods and results Electrocardiograms of 352 healthy subjects, 941 survivors of acute myocardial infarction (MI), and 605 patients recorded prior to the implantation of automatic defibrillator [implantable cardioverter defibrillator (ICD)] were used to obtain QRS-T angle measurements by the maximum R to T (MRT), area R to T (ART), and total cosine R to T (TCRT) methods. The results were compared in terms of physiologic reproducibility and power to predict mortality in the cardiac patients during 5-year follow-up. Maximum R to T results were significantly less reproducible compared to the other two methods. Among both survivors of acute MI and ICD recipients, TCRT method was statistically significantly more powerful in predicting mortality during follow-up. Among the acute MI survivors, increased spatial QRS-T angle (TCRT assessment) was particularly powerful in predicting sudden cardiac death with the area under the receiver operator characteristic of 78% (90% confidence interval 63 90%). Among the ICD recipients, TCRT also predicted mortality significantly among patients with prolonged QRS complex duration when the spatial orientation of the QRS complex is poorly defined. Conclusion The TCRT method for the assessment of spatial QRS-T angle appears to offer important advantages in comparison to other methods of measurement. This approach should be included in future clinical studies of the QRS-T angle. The TCRT method might also be a reasonable candidate for the standardization of the QRS-T angle assessment.
ER  -

HNATKOVA, Katerina, Joachim SEEGERS, Petra BARTHEL, Tomáš NOVOTNÝ, Peter SMETANA, Markus ZABEL, Georg SCHMIDT and Marek MALIK. Clinical value of different QRS-Tangle expressions. \textit{EP Europace}. Oxford: Oxford University Press, 2018, vol.~20, No~8, p.~1352-1361. ISSN~1099-5129. Available from: https://dx.doi.org/10.1093/europace/eux246.

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