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ECG-derived spatial QRS-T angle is strongly associated with hypertrophic cardiomyopathy

Daniel Cortez1, Todd T Schlegel2, Michael J Ackerman3

  • 1Electrophysiology, Milton S. Hershey Medical Center, Hershey, USA; Clinical Sciences, Lund University, Lund, Sweden.

Journal of Electrocardiology
|November 15, 2016
PubMed

Insights

Vectorcardiography (VCG) spatial QRS-T angles effectively differentiate hypertrophic cardiomyopathy (HCM) patients from controls, outperforming Seattle criteria. VCG shows potential for identifying genotype-positive HCM patients.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Genetics

Background:

  • Hypertrophic cardiomyopathy (HCM) is a genetic heart condition and a leading cause of sudden cardiac death (SCD) in young individuals.
  • Genotype-positive HCM is linked to increased risks of systolic dysfunction, heart failure, and SCD.

Purpose of the Study:

  • To evaluate the diagnostic capability of electrocardiography (ECG)-derived vectorcardiography (VCG) parameters in a large cohort of genotyped HCM patients.
  • To compare the diagnostic utility of VCG parameters against traditional Seattle ECG criteria.

Main Methods:

  • Analysis of 12-lead ECGs from 967 HCM patients and healthy controls, with genetic testing performed on 1053 patients.
  • Computerized derivation of VCG parameters including spatial QRS-T angles, spatial ventricular gradient (SVG), and Tpeak-Tend (TpTe) intervals.
  • Comparison of VCG parameter performance with Seattle ECG criteria for HCM diagnosis.

Main Results:

  • Spatial peaks and mean QRS-T angles were significantly higher in HCM patients than controls (P<0.001).
  • VCG spatial QRS-T angles identified 94% (peaks) and 84% (mean) of HCM patients, surpassing Seattle criteria (70.7%, P<0.001).
  • Genotype-positive HCM patients exhibited distinct VCG profiles (higher spatial mean QRS-T angles, spatial TpTe; lower SVG) compared to genotype-negative patients.

Conclusions:

  • ECG-derived spatial QRS-T angles offer a superior diagnostic tool for differentiating HCM patients from controls compared to Seattle criteria.
  • The clinical utility of VCG in distinguishing between genotype-negative and genotype-positive HCM patients requires further investigation.
Abstract

Keywords:
GenotypeHCMSeattle criteriaVectorcardiography

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