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QRS-T-angle in Patients with ST-Segment Elevation Myocardial Infarction (STEMI) - a Comparison with Cardiac Magnetic

B Zadeh1,2, J M Wambach1,2, M Lambers1,2

  • 1Department of Cardiology and Angiology, Contilia Heart and Vascular Center, Elisabeth-Krankenhaus Essen, Essen, Germany.

International Journal of Medical Sciences
|September 14, 2020
PubMed

Insights

The QRS-T angle on an electrocardiogram (EKG) is linked to greater myocardial damage in ST-segment myocardial infarction (STEMI) patients. A larger QRS-T angle indicates more extensive heart muscle damage, as confirmed by cardiovascular magnetic resonance imaging.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Electrocardiography

Background:

  • The QRS-T angle on surface electrocardiograms (EKG) shows prognostic value in coronary artery disease.
  • Cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE) provides detailed imaging of myocardial damage.

Purpose of the Study:

  • To investigate the association between the QRS-T angle and the extent of myocardial damage assessed by LGE.
  • To evaluate the relationship between QRS-T angle and infarct size in ST-segment myocardial infarction (STEMI) patients.

Main Methods:

  • 169 STEMI patients underwent EKG for QRS-T angle calculation and CMR with LGE for infarct size assessment within the first week.
  • Patients were categorized based on QRS-T angle: abnormal (≥ 90 degrees) versus normal (< 90 degrees).

Main Results:

  • Patients with a QRS-T angle ≥ 90 degrees exhibited significantly larger infarct sizes (36.5±12.4 vs. 13.3±9.5; p<0.001).
  • An abnormal QRS-T angle was associated with lower ejection fraction (42.9±12.1% vs. 50.6±10.6%; p<0.001).

Conclusions:

  • The extent of myocardial damage, quantified by LGE, is significantly associated with a larger QRS-T angle.
  • The QRS-T angle derived from surface EKG is a valuable indicator of myocardial damage extent in STEMI.

Keywords:
QRS-T angleST-segment elevation myocardial infarctioncardiovascular magnetic resonancelate gadolinium enhancement

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