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Frontal plane T-wave axis orientation predicts coronary events: Findings from the Moli-sani study

Licia Iacoviello1, Marialaura Bonaccio2, Augusto Di Castelnuovo2

  • 1Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Isernia, Italy; Department of Medicine and Surgery, University of Insubria, Varese, Italy.

Atherosclerosis
|August 4, 2017
PubMed

Insights

An abnormal frontal plane T-wave axis (T axis) on an ECG is linked to higher risks of coronary heart disease (CHD) and heart failure (HF). This association, independent of other risk factors, is partly explained by elevated cardiac biomarkers.

Area of Science:

  • Cardiology
  • Electrocardiography
  • Cardiovascular Disease Risk Stratification

Background:

  • The frontal plane T-wave axis (T axis) is a key indicator of ventricular repolarization.
  • Investigating T axis as a predictor for various cardiovascular outcomes is crucial for risk assessment.

Purpose of the Study:

  • To determine the association between T axis orientation and the risk of coronary heart disease (CHD), heart failure (HF), atrial fibrillation (AF), stroke, and cardiovascular (CVD) mortality.
  • To explore whether this association is independent of traditional CVD risk factors and other ECG abnormalities.

Main Methods:

  • Analysis of data from 21,287 Moli-sani participants (age ≥35 years) from the general Italian population, initially free of CVD.
  • Median follow-up duration of 4.4 years, with T axis measured from standard 12-lead resting ECGs.
  • Statistical analysis adjusted for CVD risk factors, ECG abnormalities, hs-troponin I, hs-NT-proBNP, and inflammation markers.

Main Results:

  • Abnormal T axis significantly increased the risk of CHD, HF, AF, and CVD mortality after adjusting for CVD risk factors.
  • The association with CHD and HF remained significant after further adjustment for ECG abnormalities.
  • Elevated hs-troponin I and hs-NT-proBNP levels partially explained the association between abnormal T axis and CHD risk.

Conclusions:

  • An abnormal T axis orientation is an independent predictor of increased risk for CHD and HF.
  • Increased levels of hs-troponin I and hs-NT-proBNP contribute to the observed association.
  • T axis assessment may enhance cardiovascular risk stratification.
Abstract

Keywords:
Cardiovascular diseaseECGHeart failurePopulation studyT-wave axisVentricular repolarisation

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