Metabolic Syndrome and Abnormal Electrocardiographic Frontal QRS-T Angle in Indonesian Patients

Background and Objectives: Metabolic syndrome (MetS) increases the cardiovascular disease (CVD) risk, including sudden cardiac death.Ventricular repolarization heterogeneity is a marker of CVD, which can be predicted by 12-lead electrocardiogram (ECG) frontal QRS-T angle.This study investigated whether MetS and its components are related to abnormal frontal QRS-T angle.Methods: We obtained anthropometric measurements, blood samples, and 12-lead ECGs from adult participants, excluding those with coronary heart disease.MetS was defined as the presence of 3 of the following 5 components: central obesity, hypertension, diabetes mellitus, elevated triglyceride, and low high-density lipoprotein cholesterol.Frontal QRS-T angle was defined as the difference between the QRS and T axes (QRS axis -T axis) and was categorized as normal (≤90°) or abnormal (>90°). Results:We enrolled 1,017 participants (mean age, 59±10 years).The prevalence of MetS was 51%, and the main component was hypertension (87.5%).The mean frontal QRS-T angle did not differ statistically between MetS and non-MetS (29±29° vs. 26±25°, respectively; p=0.083), and the prevalence of abnormal frontal QRS-T angle was comparable (4.4% vs. 3.6%, respectively; p=0.372).Hypertension (odds ratio [OR], 3.94, 95% confidence interval [CI], 1.47-11.97,p=0.039) and age ≥60 years (OR, 2.08, 95% CI, 1.80-4.70,p=0.043) were independent predictors for abnormal frontal QRS-T angle.Conclusions: Among Indonesians, MetS was not statistically associated with an abnormal frontal QRS-T angle; however, significantly increased odds of abnormal frontal QRS-T angles were found with hypertension.