Key result
Wider frontal QRS-T angle linked to ~3.5-fold higher odds of advanced liver fibrosis in stable angina.
Why the study?
The frontal QRS-T angle and non-alcoholic fatty liver disease fibrosis score (NFS) both relate to atherosclerotic cardiovascular disease, but their potential correlation in stable angina pectoris was unexamined.
Does the frontal QRS-T angle correlate with the NAFLD fibrosis score in patients with stable angina pectoris?
Cross-Sectional (n=177)
No
Does the frontal QRS-T angle correlate with the NAFLD fibrosis score in patients with stable angina pectoris?
An increased frontal QRS-T angle independently predicts advanced NAFLD fibrosis in patients with stable angina pectoris, suggesting it may serve as an accessible ECG marker for shared cardiovascular and metabolic risk.
Wider fQRS-T angle may flag advanced NAFLD fibrosis in stable angina; hypothesis-generating and requires prospective validation.
Aim: The frontal QRS-T (fQRS-T) angle serves as an electrocardiography indicator that visually represents the disparity between the frontal QRS axis and the T axis. The heterogeneity between cardiac depolarization and repolarization rises with an increase in the fQRS-T angle. Prior research has demonstrated a relationship between the fQRS-T angle and the extent of atherosclerosis, along with the risk of cardiovascular mortality. The non-alcoholic fatty liver disease fibrosis score (NFS) is a non-invasive scoring tool used to quantify the degree of liver fibrosis in individuals with non-alcoholic fatty liver disease (NAFLD). Non-alcoholic fatty liver disease increases the risk of atherosclerotic cardiovascular disease, which can be predicted using the NFS. The objective of this study is to examine the potential correlation between the fQRS-T angle and NFS in patients with stable angina pectoris. Materials and Methods: This cross-sectional study included 177 (48 women) non-alcoholic patients who underwent coronary angiography due to stable angina pectoris. Individual NFS values were calculated using clinical and laboratory data. Patients were categorized into two groups based on a NFS threshold value of 0.67. Following a minimum fasting period of 12 h, biochemical laboratory parameters were acquired using a peripheral venous sample, and electrocardiographic data were recorded. Results: The univariate logistic regression analysis revealed significant associations between hypertension (p = 0.018), coronary artery disease (p = 0.014), neutrophil (p = 0.024), hemoglobin (p = 0.038), and low-density lipoprotein (LDL, p = 0.007) with the NFS. The electrocardiographic variables related to the score included the QRS duration (p = 0.015), Pmax (p = 0.026), QTC interval (p = 0.02), and fQRS-T angle (p < 0.001). In the multivariate logistic regression analysis, NFS was independently associated with LDL (OR: 0.984, 95% CI: 0.970–0.998, p = 0.024) and fQRS-T angle (OR: 3.472, 95% CI: 1.886–6.395, p < 0.001). Conclusions: The FQRS-T angle may exhibit a distinct correlation with NAFLD. Extensive investigations should validate this link, since the fibrosis score can serve as an effective tool for monitoring patients prior to the onset of clinical symptoms associated with liver fibrosis.
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Özyıldız et al. (2025) conducted a cross-sectional in Stable angina pectoris (n=177). Frontal QRS-T (fQRS-T) angle was evaluated on NAFLD fibrosis score (NFS) ≥ 0.67 (OR 3.472, 95% CI 1.886-6.395, p=<0.001). A wider frontal QRS-T angle was independently associated with a high non-alcoholic fatty liver disease fibrosis score (OR 3.472, p<0.001) in patients with stable angina pectoris.
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