In Hypertrophic Cardiomyopathy, the Spatial Peaks QRS-T Angle Identifies Those With Sustained Ventricular Arrhythmias

Area of Science:

• Cardiology
• Electrocardiography
• Medical Diagnostics

Background:

• The spatial peaks QRS-T (SPQRS-T) angle is a novel electrocardiographic measure.
• This angle has shown potential in differentiating hypertrophic cardiomyopathy (HCM) patients from healthy individuals.
• An increased SPQRS-T angle has been linked to arrhythmia risk in various cardiac conditions.

Purpose of the Study:

• To investigate the efficacy of the SPQRS-T angle in identifying HCM patients with sustained ventricular arrhythmias (VAs).
• To assess the SPQRS-T angle's ability to detect HCM patients with advanced heart failure (New York Heart Association class III/IV).

Main Methods:

• A cohort of 100 hypertrophic cardiomyopathy patients was analyzed.
• Electrocardiographic parameters including corrected QT interval, QRS duration, and SPQRS-T angle were measured.
• Patients were categorized based on the presence or absence of sustained ventricular arrhythmias (>30 seconds).

Main Results:

• The SPQRS-T angle significantly differentiated HCM patients with VAs from those without (P < 0.001).
• At a threshold of 124.1 degrees, the SPQRS-T angle demonstrated a positive predictive value of 36.7% and a negative predictive value of 96.1% for VAs.
• The corrected QT interval also identified VAs (P = 0.018), but with lower predictive values compared to the SPQRS-T angle.

Conclusions:

• The SPQRS-T angle is a superior marker for differentiating HCM patients who have experienced ventricular arrhythmias.
• This ECG parameter holds significant potential for risk stratification in hypertrophic cardiomyopathy.