Age, gender and drug therapy influences on Tpeak-tend interval and on electrical risk score

Electrical risk score (ERS) has been proposed as easy, inexpensive test to stratify of sudden cardiac death (SCD) risk in subjects with normal left ventricular function. Potentially, aging, gender and drugs can influence ERS affecting two on six electrical markers, particularly, those based on the repolarization. Aim of this study was to establish aging, gender and drug therapy possible influences on ERS and mortality in elderly patients.

237 consecutive, low SCD risk-outpatients with asymptomatic and treated cardiovascular risk factors were analyzed. Six simple ECG markers composed ERS: heart rate (>75 bpm); left ventricular hypertrophy (Sokolow-Lyon criteria); delayed QRS transition zone (≥V4), frontal QRS-T angle (>90°), long QT_Bazett; long T peak to T end interval (T_p-e). We obtained ERS in 237 outpatients, grouped according age (<40 ys, ≥40 to <60 ys and ≥60 ys), gender and drug therapy with or without possible influence on the repolarization phase.

Two-hundred-thirty-seven patients were grouped respectively in the following age classes: <40 years old; ≥40 to <60 years old and ≥60 years old. ERS (p < 0.05), QT_Bazett (p < 0.001), T_p-e (p < 0.001) were higher in older subjects independently from gender, drug therapy and cardiovascular comorbidity. After two years we reported a 7.3% of mortality in the older groups; age (deceased versus survivors: 80 ± 4 versus 73 ± 7 years, p < 0.05) and T_p-e (deceased versus survivors: 117 ± 15 versus 93 ± 21 ms, p < 0.05) were significantly lower in survivors, multivariable logistic regression analysis selected only the T_p-e as significant risk factor for total mortality (odd ratio 1.06, 95% CI: 1.01-1.12, p < 0.05).

Aging was associated to the ERS and repolarization phase derangement. T_p-e should be considered a marker of total mortality rather than SCD in the over sixty years old patients.