Key result
A wider frontal planar QRS-T angle was significantly associated with a history of hypertension (p=0.001) and larger left main coronary artery diameter (p=0.004) in patients with normal coronaries.
Why the study?
Is the frontal planar QRS-T angle associated with clinical and angiographic parameters in patients without angiographically apparent coronary atherosclerosis?
Observational (n=307)
Is the frontal planar QRS-T angle associated with clinical and angiographic parameters in patients without angiographically apparent coronary atherosclerosis?
Answers are grounded in this paper and cite their sources.
In patients with normal coronary arteries, a wider frontal planar QRS-T angle is independently associated with hypertension, prolonged QTc, and larger left main coronary artery diameter, suggesting its potential as a marker of ventricular repolarization heterogeneity.
OBJECTIVE: The present study was undertaken to investigate the prognostic value of the frontal planar QRS-T angle in patients without angiographically apparent coronary atherosclerosis. SUBJECTS AND METHODS: Three hundred and seven patients with normal coronary arteries on coronary angiography were included. The absolute difference between the frontal QRS- and T-wave axes was defined as the frontal planar QRS-T angle, and patients were divided into 3 subgroups based on the frontal planar QRS-T angle (<45, 45-90, and >90°). Demographic, clinical, laboratory, and angiographic data were compared between groups. Based on the regression analysis results, patients were recategorized into 4 groups according to their luminal calibers of left main coronary artery (LMCA) and history of hypertension (HT) (nonhypertensive LMCA ≤4.13 mm, nonhypertensive LMCA >4.13 mm, hypertensive LMCA ≤4.13 mm, and hypertensive LMCA >4.13 mm). RESULTS: The median value of the frontal planar QRS-T angle of all participants was 38°. Subjects with the widest frontal planar QRS-T angle were older (p = 0.027), were hypertensive (p = 0.001), and had higher corrected QT values (p = 0.001). Patients with the widest frontal planar QRS-T angle had larger LMCA and left anterior descending coronary artery diameters compared to subjects with a normal and borderline frontal QRS-T angle (p = 0.004 and p = 0.028, respectively). Corrected QT, HT, and LMCA diameter were found as independent predictors of the frontal planar QRS-T angle. Subjects with HT and a larger luminal caliber of LMCA had the widest frontal planar QRS-T angle. CONCLUSION: Patients with a history of HT and a larger luminal caliber of LMCA had the widest frontal planar QRS-T angle. Since HT-induced electrophysiological changes are still not well established and we observed that changes in the luminal caliber of coronary arteries are associated with an abnormal frontal QRS-T angle, the frontal QRS-T angle could serve as a marker of ventricular repolarization heterogeneity in hypertensive patients in addition to keeping track of arrhythmic events, even before overt disease.
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Güngör et al. (2016) conducted an observational in Patients without angiographically apparent coronary atherosclerosis (n=307). Frontal planar QRS-T angle vs. Subgroups based on angle (<45, 45-90, and >90°) was evaluated on Association of frontal planar QRS-T angle with clinical and angiographic parameters. A wider frontal planar QRS-T angle was significantly associated with a history of hypertension (p=0.001) and larger left main coronary artery diameter (p=0.004) in patients with normal coronaries.
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