Key result
The prevalence of abnormal spatial peak and mean QRS-T angles varied by clinical status, ranging from 2.5% in apparently healthy participants to 21.2% in those with diabetes mellitus.
Why the study?
Spatial peak and mean QRS-T angles are scientifically but not clinically established risk factors for cardiovascular events and cardiac death, warranting comparison and evaluation of their associations with hypertension and diabetes.
Cross-Sectional (n=1,094)
Absolute Event Rate: 21.2% vs 2.5%
Spatial peak and mean QRS-T angles are complementary electrophysiological measures whose abnormalities are strongly associated with diabetes and hypertension.
Higher prevalence in diabetes supports hypothesis generation; prospective validation needed before clinical use.
BACKGROUND: The spatial peak and mean QRS-T angles are scientifically but not clinically established risk factors for cardiovascular events including cardiac death. The study aims were to compare these angles, assess their association with hypertension (HT) and diabetes mellitus (DM), and explore the relation between the mean QRS-T angle and the ventricular gradient (VG; reflecting electrical heterogeneity), which both are derived from the QRSarea and Tarea vectors. METHODS: Altogether 1094 participants (aged 50-65 years, 550 women) from the pilot of the population-based Swedish CArdioPulmonary bioImage Study with Frank vectorcardiographic recordings were included and divided into 5 subgroups: apparently healthy n = 320; HT n = 311; DM n = 33; DM + HT n = 53; miscellaneous conditions n = 377. Abnormal peak and mean QRS-T angles were defined as >95th percentile. RESULTS: Peak QRS-T angles were generally narrower than the mean QRS-T angles; both were narrower in women than in men. Abnormal peak (>124°) and/or mean (>119°) QRS-T angles were found in 73 participants (6.7%). The concordance regarding abnormal versus normal-borderline QRS-T angles was good (Cohen's kappa 0.61). The prevalence of abnormal angles varied from 2.5% in healthy to 21.2% in DM. There was an inverse logarithmical relation between the mean QRS-T angle and the VG. CONCLUSIONS: The peak and mean QRS-T angles are not interchangeable but complementary. DM, HT, sex and absence of disease are important determinants of both QRS-T angles. The mean QRS-T angle and the VG relationship is complex. All three VCG derived measures reflect related but differing electrophysiological properties and have potential prognostic value vis-à-vis cardiovascular events.
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Bergfeldt et al. (2020) conducted a cross-sectional in Hypertension and Diabetes Mellitus (n=1,094). Diabetes Mellitus and Hypertension vs. Apparently healthy participants was evaluated on Prevalence of abnormal peak and/or mean QRS-T angles. The prevalence of abnormal spatial peak and mean QRS-T angles varied by clinical status, ranging from 2.5% in apparently healthy participants to 21.2% in those with diabetes mellitus.
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