Related Experiment Videos
T-loop morphology as a marker of cardiac events in the elderly
J A Kors1, M C de Bruyne, A W Hoes
1Department of Medical Informatics, Erasmus University Medical School, Rotterdam, The Netherlands.
Insights
Abnormalities in T-loop morphology and T axis on electrocardiograms (ECGs) strongly predict cardiac events in older adults. These findings highlight new ECG markers for assessing cardiac risk in the elderly population.
Area of Science:
- Cardiology
- Medical Diagnostics
- Geriatric Medicine
Background:
- Electrocardiographic (ECG) ST-T wave changes are known cardiac event predictors.
- However, they imperfectly capture T-loop morphology, limiting predictive accuracy.
Purpose of the Study:
- To investigate the predictive value of T-loop abnormality using vectorcardiographic (VCG) parameters for cardiac events.
- To assess the predictive value of the T axis, an easily obtainable T-loop parameter.
Main Methods:
- A prospective cohort study of 5,815 elderly individuals.
- VCGs were reconstructed from standard 12-lead ECGs and analyzed by computer for T-loop morphology and T axis.
- Follow-up duration was 3-6 years (mean 4 years).
Main Results:
- Abnormal T-loop morphology was associated with significantly increased risks for fatal (HR 4.3) and nonfatal (HR 3.0) cardiac events.
- Abnormal T axis also showed significant predictive value, only slightly lower than T-loop morphology.
- These risks remained highly significant after adjusting for established cardiovascular risk factors.
Conclusions:
- T-loop and T-axis abnormalities are strong, independent risk indicators for cardiac events in the elderly.
- VCG-derived T-loop parameters offer enhanced prediction of cardiac events beyond traditional ECG findings.
- These findings suggest potential for improved cardiac risk stratification in older populations using advanced ECG analysis.
Abstract:
ST-T wave changes of electrocardiographic (ECG) leads have long been recognized as predictors of future cardiac events, but they only imperfectly characterize T-loop morphology. Using vectorcardiographic (VCG) parameters, we investigated the predictive value of T-loop abnormality for fatal and nonfatal cardiac events in a prospective cohort study among 5,815 elderly. Separately, the predictive value of an easily obtainable T-loop parameter, the T axis, was also assessed. Measurements were determined by a computer program, using VCGs reconstructed from the standard 12-lead ECGs. During the 3 to 6 (mean 4) years of follow-up, 166 fatal and 193 nonfatal cardiac events occurred. Subjects with an abnormal T-loop morphology had increased risks for fatal cardiac events (hazard ratio 4.3; 95% CI 3.0-6.4) and nonfatal cardiac events (3.0; 1.9-4.8). Risks associated with an abnormal T axis alone were only slightly lower. Additional adjustment for established cardiovascular risk indicators resulted in lower, but still highly significant risks. Both T-loop and T-axis abnormalities appear to be strong, independent risk indicators of cardiac events in the elderly.