T-loop morphology as a marker of cardiac events in the elderly

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J A Kors1, M C de Bruyne, A W Hoes

  • 1Department of Medical Informatics, Erasmus University Medical School, Rotterdam, The Netherlands.

Journal of Electrocardiology
|February 13, 1999
PubMed

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.

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