ANDRŠOVÁ, Irena, Katerina HNATKOVA, Ondřej TOMAN, Martina ŠIŠÁKOVÁ, Peter SMETANA, Katharina M. HUSTER, Petra BARTHEL, Tomáš NOVOTNÝ, Georg SCHMIDT and Marek MALÍK. Intra-subject stability of different expressions of spatial QRS-T angle and their relationship to heart rate. Frontiers in Physiology. Lausanne: FRONTIERS MEDIA SA, 2022, vol. 13, August 2022, p. 1-28. ISSN 1664-042X. Available from: https://dx.doi.org/10.3389/fphys.2022.939633.
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Basic information
Original name Intra-subject stability of different expressions of spatial QRS-T angle and their relationship to heart rate
Authors ANDRŠOVÁ, Irena (203 Czech Republic, belonging to the institution), Katerina HNATKOVA (203 Czech Republic, guarantor), Ondřej TOMAN (203 Czech Republic, belonging to the institution), Martina ŠIŠÁKOVÁ (203 Czech Republic, belonging to the institution), Peter SMETANA, Katharina M. HUSTER, Petra BARTHEL, Tomáš NOVOTNÝ (203 Czech Republic, belonging to the institution), Georg SCHMIDT and Marek MALÍK (203 Czech Republic, belonging to the institution).
Edition Frontiers in Physiology, Lausanne, FRONTIERS MEDIA SA, 2022, 1664-042X.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30201 Cardiac and Cardiovascular systems
Country of publisher Switzerland
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 4.000
RIV identification code RIV/00216224:14110/22:00128071
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.3389/fphys.2022.939633
UT WoS 000874799100001
Keywords in English healthy volunteers; long-term ECG; ECG measurements; spatial QRS-T angle; heart rate; heart rate hysteresis; polynomial regression; sex differences
Tags 14110211, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 18/1/2023 09:37.
Abstract
Three-dimensional angle between the QRS complex and T wave vectors is a known powerful cardiovascular risk predictor. Nevertheless, several physiological properties of the angle are unknown or poorly understood. These include, among others, intra-subject profiles and stability of the angle relationship to heart rate, characteristics of angle/heart-rate hysteresis, and the changes of these characteristics with different modes of QRS-T angle calculation. These characteristics were investigated in long-term 12-lead Holter recordings of 523 healthy volunteers (259 females). Three different algorithmic methods for the angle computation were based on maximal vector magnitude of QRS and T wave loops, areas under the QRS complex and T wave curvatures in orthogonal leads, and weighted integration of all QRS and T wave vectors moving around the respective 3-dimensional loops. These methods were applied to orthogonal leads derived either by a uniform conversion matrix or by singular value decomposition (SVD) of the original 12-lead ECG, giving 6 possible ways of expressing the angle. Heart rate hysteresis was assessed using the exponential decay models. All these methods were used to measure the angle in 659,313 representative waveforms of individual 10-s ECG samples and in 7,350,733 individual beats contained in the same 10-s samples. With all measurement methods, the measured angles fitted second-degree polynomial regressions to the underlying heart rate. Independent of the measurement method, the angles were found significantly narrower in females (p < 0.00001) with the differences to males between 10 degrees and 20 degrees, suggesting that in future risk-assessment studies, different angle dichotomies are needed for both sexes. The integrative method combined with SVD leads showed the highest intra-subject reproducibility (p < 0.00001). No reproducible delay between heart rate changes and QRS-T angle changes was found. This was interpreted as a suggestion that the measurement of QRS-T angle might offer direct assessment of cardiac autonomic responsiveness at the ventricular level.
Links
MUNI/A/1450/2021, interní kód MUName: Nevyřešené otázky a nové metody hodnocení elektrokardiografického signálu a struktur myokardu III. (Acronym: ECG2022)
Investor: Masaryk University
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