Heart Rate Dependency and Inter-Lead Variability of the T Peak - T End Intervals

@article{1727478,
   author = {Andršová, Irena and Hnatkova, Katerina and Šišáková, Martina and Toman, Ondřej and Smetana, Peter and Huster, Katharina M. and Barthel, Petra and Novotný, Tomáš and Schmidt, Georg and Malík, Marek},
   article_location = {Lausanne},
   article_number = {DEC 2020},
   doi = {http://dx.doi.org/10.3389/fphys.2020.595815},
   keywords = {T wave peak; T wave spatial loop; heart rate dependency; ECG lead comparison; sex differences},
   language = {eng},
   issn = {1664-042X},
   journal = {Frontiers in Physiology},
   title = {Heart Rate Dependency and Inter-Lead Variability of the T Peak - T End Intervals},
   url = {https://www.frontiersin.org/articles/10.3389/fphys.2020.595815/full},
   volume = {11},
   year = {2020}
}

TY  - JOUR
ID  - 1727478
AU  - Andršová, Irena - Hnatkova, Katerina - Šišáková, Martina - Toman, Ondřej - Smetana, Peter - Huster, Katharina M. - Barthel, Petra - Novotný, Tomáš - Schmidt, Georg - Malík, Marek
PY  - 2020
TI  - Heart Rate Dependency and Inter-Lead Variability of the T Peak - T End Intervals
JF  - Frontiers in Physiology
VL  - 11
IS  - DEC 2020
SP  - 1-19
EP  - 1-19
PB  - Frontiers Media
SN  - 1664042X
KW  - T wave peak
KW  - T wave spatial loop
KW  - heart rate dependency
KW  - ECG lead comparison
KW  - sex differences
UR  - https://www.frontiersin.org/articles/10.3389/fphys.2020.595815/full
L2  - https://www.frontiersin.org/articles/10.3389/fphys.2020.595815/full
N2  - The electrocardiographic (ECG) assessment of the T peak-T end (Tpe) intervals has been used in many clinical studies, but several related physiological aspects have not been reported. Specifically, the sources of the Tpe differences between different ECG leads have not been systematically researched, the relationship of Tpe duration to underlying heart rate has not been firmly established, and little is known about the mutual correspondence of Tpe intervals measured in different ECG leads. This study evaluated 796,620 10-s 12-lead ECGs obtained from long-term Holters recorded in 639 healthy subjects (311 female) aged 33.8 +/- 9.4 years. For each ECG, transformation to orthogonal XYZ lead was used to measure Tpe in the orthogonal vector magnitude (used as a reference for lead-to-lead comparisons) and to construct a three-dimensional T wave loop. The loop roundness was expressed by a ratio between its circumference and length. These ratios were significantly related to the standard deviation of Tpe durations in different ECG leads. At the underlying heart rate of 60 beats per minute, Tpe intervals were shorter in female than in male individuals (82.5 +/- 5.6 vs 90.0 +/- 6.5 ms, p < 0.0001). When studying linear slopes between Tpe intervals measured in different leads and the underlying heart rate, we found only minimal heart rate dependency, which was not systematic across the ECG leads and/or across the population. For any ECG lead, positive Tpe/RR slope was found in some subjects (e.g., 79 and 25% of subjects for V2 and V4 measurements, respectively) and a negative Tpe/RR slope in other subjects (e.g., 40 and 65% for V6 and V5, respectively). The steepest positive and negative Tpe/RR slopes were found for measurements in lead V2 and V4, respectively. In all leads, the Tpe/RR slope values were close to zero, indicating, on average, Tpe changes well below 2 ms for RR interval changes of 100 ms. On average, longest Tpe intervals were measured in lead V2, the shortest in lead III. The study concludes that the Tpe intervals measured in different leads cannot be combined. Irrespective of the measured ECG lead, the Tpe interval is not systematically heart rate dependent, and no heart rate correction should be used in clinical Tpe investigations.
ER  - 

ANDRŠOVÁ, Irena, Katerina HNATKOVA, Martina ŠIŠÁKOVÁ, Ondřej TOMAN, Peter SMETANA, Katharina M. HUSTER, Petra BARTHEL, Tomáš NOVOTNÝ, Georg SCHMIDT and Marek MALÍK. Heart Rate Dependency and Inter-Lead Variability of the T Peak - T End Intervals. \textit{Frontiers in Physiology}. Lausanne: Frontiers Media, 2020, vol.~11, DEC 2020, p.~1-19. ISSN~1664-042X. Available from: https://dx.doi.org/10.3389/fphys.2020.595815.