Elevated frontal QRS-T angle as a predictor of cardiovascular risk in graves' disease: A comparative study
Zhen Wang1, Jia Xu2, Ting-Ting Fan1
1Department of Cardiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China.
Insights
The frontal QRS-T angle may predict cardiovascular risks in Graves' disease (GD) patients. An increased angle (≥90°) is linked to higher mortality, ventricular fibrillation, and heart failure hospitalizations in GD.
Area of Science:
- Cardiology
- Endocrinology
- Medical Diagnostics
Background:
- Graves' disease (GD) is associated with cardiovascular complications.
- Non-invasive predictors for cardiovascular outcomes in GD patients are limited.
- The frontal QRS-T (fQRS-T) angle's predictive value in GD requires investigation.
Purpose of the Study:
- To evaluate the frontal QRS-T angle as a predictor of mortality and cardiovascular outcomes in Graves' disease patients.
- To compare fQRS-T angle prevalence in GD patients versus healthy controls.
- To identify predictors of hyperthyroid heart disease.
Main Methods:
- Retrospective analysis of electrocardiogram (ECG) parameters in 291 GD patients and 96 controls.
- Categorization of GD patients based on hyperthyroid heart disease.
- Logistic and Cox regression analyses, and Kaplan-Meier survival analysis over a five-year follow-up.
Main Results:
- GD patients showed a significantly higher prevalence of fQRS-T angle ≥90° compared to controls (p < 0.001).
- An fQRS-T angle ≥90° was more common in GD patients with hyperthyroid heart disease (p < 0.001).
- Increased fQRS-T angle (≥90°) independently predicted hospitalization for heart failure (HR 5.04, p < 0.001) and was associated with higher all-cause mortality or ventricular fibrillation (p < 0.001).
Conclusions:
- An elevated frontal QRS-T angle may indicate increased cardiovascular risk in Graves' disease.
- The fQRS-T angle shows potential as a novel, hypothesis-generating marker for cardiovascular risk stratification in GD.
- Further prospective research is warranted to confirm these findings.
Backgrounds:
Graves' disease (GD) is linked to cardiovascular complications, but reliable non-invasive predictors are limited. This study aimed to assess whether the frontal QRS-T (fQRS-T) angle could predict mortality and cardiovascular outcomes in GD patients.
Methods:
Initially, we conducted a retrospective analysis of electrocardiogram (ECG) parameters from 291 GD patients compared with 96 healthy controls. GD patients were then categorized based on the presence of hyperthyroid heart disease. Using logistic regression, we identified predictors of cardiovascular outcomes. Subsequently, a retrospective cohort study followed 41 patients with an fQRS-T angle ≥90° and 162 controls over five years, assessing all-cause mortality, ventricular fibrillation (VF) and first hospitalization for heart failure (HF).
Results:
Initial analysis showed that a significantly higher proportion of GD patients had an fQRS-T angle ≥90° compared to healthy controls (p < 0.001). Among GD patients, those with hyperthyroid heart disease were more likely to have an fQRS-T angle ≥90° (p < 0.001). Multivariate logistic regression analysis revealed that age, fQRS-T angle, thyroxine (T4), and platelet were independent predictors of hyperthyroid heart disease. In the cohort study, Kaplan-Meier analysis showed significant differences in all-cause mortality or VF (p < 0.001) and first hospitalization for HF (p < 0.001) between the groups. Multivariate Cox regression analyses shown QRS-T angle ≥90° significantly increased the risk of hospitalization for HF (HR 5.04, 95 % CI 2.59-9.81, p < 0.001).
Conclusions:
An increased fQRS-T angle may be associated with elevated cardiovascular risk in patients with GD. These preliminary findings suggest that fQRS-T angle could serve as a hypothesis-generating marker for further prospective research.
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