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Spatial QRS-T angle variants for prediction of all-cause mortality
Karina Kück1, Jonas L Isaksen2, Claus Graff3
1Laboratory of Experimental Cardiology, Department of Biomedical Sciences, University of Copenhagen, Denmark.
Background:
Many variants of the spatial QRS-T angle (QRS-Ta) are in use. We aimed to identify the best QRS-Ta for all-cause mortality prediction among different variants.
Methods:
6667 individuals from the Inter99 General Population Study were followed for a median of 12.7 years. Vectorcardiograms were calculated using the Kors and Inverse Dower matrices. The QRS-Ta was calculated using both mean and peak vectors of the QRS- and T-loops. Hazard ratios (HR) for abnormal QRS-Tas were calculated using a Cox's Proportional Hazard Model.
Results:
The highest HR and largest AUC for all-cause mortality was obtained with the Kors matrix and the mean vector (HR = 2.2, 95% confidence interval: [1.38;3.43] p < 0.001, in men). There was interaction with the orientation of the QRS-T plane.
Conclusion:
For optimal prediction of all-cause mortality, the mean vectors in the QRS- and T-loops of the Kors-derived vectorcardiogram should be used. QRS-T plane orientation affects mortality prediction.
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