Diagnostic and prognostic significance of QRS-T angle

Blinova, E V; Sakhnova, T A; Yurasova, E. S.

doi:10.26442/00403660.2020.09.000752

Cited by 3 publications

(2 citation statements)

References 46 publications

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“…В клинических исследованиях в зависимости от разных подходов к определению пороговых значений и разных задач исследований верхняя граница fQRS-T варьировала от 42° (граница верхнего терциля показателя у больных с подозрением на NSTEMI) [5] до 104° (граница верхнего терциля показателя у больных с острым коронарным синдромом) [3], причем в обоих этих исследованиях прослеживалась связь увеличения fQRS-T с более высокой 2-летней смертностью. Наиболее часто при исследовании связи fQRS-T со смертностью и с сердечно-сосудистыми осложнениями у больных с разными формами патологии используют границу 90° [1].…”

Section: Discussionunclassified

“…Применение в этих целях такого недорогого и широкодоступного метода как электрокардиография может оказаться достаточно перспективным. К прогностическим показателям электрокардиограммы, привлекающим в последние годы все большее внимание исследователей, относятся, в частности, «пространственный угол QRS-T» (sQRS-T) и «фронтальный угол QRS-T» (fQRS-T), отражающие расхождение в пространстве векторов де-и реполяризации желудочков [1].…”

Section: Introductionunclassified

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Factors associated with an increase in spatial and frontal QRS-T angles in patients with anterior myocardial infarction

et al. 2021

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Aim To determine existence of a relationship between any clinical, echocardiographic and coronarographic factors and increased spatial QRS-T (sQRS-T) angle and frontal QRS-T (fQRS-T) angle in patients with anterior myocardial infarction.Material and methods This study included 137 patients aged 62 [53; 72] years with anterior acute myocardial infarction managed at the A.L. Myasnikov Institute of Clinical Cardiology. fQRS-T was calculated as the module of difference between the frontal plane QRS complex axis and the T wave axis. sQRS-T was calculated as a spatial angle between QRS and T integral vectors from a synthesized vectorcardiogram.Results fQRS-T values for a group (median [25th; 75th percentile]) were 81 [37; 120]°; sQRS-T values were 114 [80; 141]°. The correlation coefficient between fQRS-T and sQRS-T values was 0.41 (p<0.001). fQRS-T weakly but statistically significantly correlated with patients’ age (r=0.28; p=0.001), left ventricular ejection fraction (LV EF, r= –0.22; p=0.01), and glomerular filtration rate (r=–0.32; p=0.0002). sQRS-T weakly but statistically significantly correlated with left ventricular end-diastolic dimension (r=0.24; p=0.0048), LV EF (r=–0.28; p=0.0009), and the number of affected segments according to echocardiography data (r=0.27; p=0.002). fQRS-T values were significantly higher in the presence of concurrent arterial hypertension. sQRS-T values were significantly higher in the presence of a history of chronic heart failure. Both fQRS-T and sQRS-T values increased with increasing number of affected blood vessels and Killip class of acute heart failure.Conclusion In patients after anterior acute myocardial infarction, increases in fQRS-T and sQRS-T are associated with more severe damage of the vasculature, decreased LV EF, and, thus, more severe clinical course of disease.

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Section: Introductionunclassified

Factors associated with an increase in spatial and frontal QRS-T angles in patients with anterior myocardial infarction

et al. 2021

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The value of the spatial QRS–T angle for assessing the severity of heart damage in patients with arterial hypertension

2021

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Aim To study the relationship between clinical, echocardiographic, and laboratory indexes with increased QRS–T spatial angle (sQRS–T) in patients with arterial hypertension (AH).Material and methods The study included 160 patients with AH, 61 (38 %) men and 99 (62 %) women aged 58 [49; 67] years. Patients with ischemic heart disease or His bundle blocks were not included. Echocardiography was used to determine the left ventricular end-diastolic dimension (LV EDD), left ventricular posterior wall thickness (LVPWT), interventricular septal thickness (IVST), relative wall thickness (RWT), left ventricular myocardial mass (LVMM), and LVMM index (LVMMI). Also, the following indexes were analyzed: office systolic and diastolic blood pressure (SBP, DBP), disease duration, body mass index, plasma levels of glucose, cholesterol, and creatinine, and glomerular filtration rate. The QRS-T spatial angle was calculated as an angle between the integral vectors QRS and T using a vectorcardiogram derived from a 12-lead digital electrocardiogram. Data are presented as median (25th percentile; 75th percentile].Results The QRS-T spatial angle for the group was 65 [43; 90]°. The QRS–T spatial angle increased with increases in the AH grade (grade 1 AH, 55 [37; 74]°; grade 2 AH, 60 [41; 82]°; grade 3 AH, 88 [62; 107]°; р<0.0001); the AH stage (stage 1, 50 [41; 77]°; stage 2, 68 [44; 93]°; stage 3, 78 [59; 110]°; р=0.0002), and the cardiovascular risk degree (low and moderate risk, 49 [37; 70]°, high risk, 62 [43; 88]° (р=0.005); very high risk, 88 [61; 117]° vs. high risk, 62 [43; 88]° (р=0.0002). The QRS–T spatial angle was greater with diabetes mellitus (78 [60; 117]°) than without it (63 [43; 89]°) (р=0.03). Weak but significant correlations were found between sQRS–T and body mass index (r=0.2; p<0.01), SBP (r=0.4; p<0.0001), DBP (r=0.2; p<0.01), LV EDD (r=0.2; p<0.01), LV PWT (r=0.3; p<0.001), IVST (r=0.3; p<0.001), LVMM (r=0.3; p<0.001), LVMMI (r=0.3; p<0.001), and blood glucose (r=0.2; p<0.01).Conclusion In patients with AH, a large QRS-T spatial angle is related with significantly higher values of SBP and DBP, LV dimension, blood glucose, and body mass index.

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Sustainability of spatial QRS-T angle of vectorcardiogram to filtration: a pilot study

Gasanova,

Drozdov,

Kozlovskaya

et al. 2023

Medicinskij alfavit

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Objective: to evaluate sustainability of spatial QRS-T angle of vectorcardiogram to filtration.Materials and methods: Vectorcardiographic records in Frank lead system obtained from 53 randomly included patients with sinus normocardia (28–80 years) were synthesized by means of special algorithm developed in our laboratory based on Bemmel’s matrix. The changes in P, Q, R, S, T amplitudes and in the values of spatial QRS-T angle were analysed at different modes of filtering (70 Гц, 40 Гц, 30 Гц) and without filtering.Results: all of the filtration modes studied diminished the amplitudes of ventricular complex components while no significant changes in the values of spatial QRS-T angle were observed.Conclusion: a new methodology for ECG and VCG parameters sustainability to signal processing (filtration) was developed and tested; the hypothesis about sustainability of spatial QRS-T angle of vectorcardiogram to filtration was approved. Taking into account that spatial QRS-T angle is known as a strong predictor of cardiac diseases, it seems perspective to be implemented in automatic ECG analysis algorythms.

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Diagnostic and prognostic significance of QRS-T angle

Cited by 3 publications

References 46 publications

Factors associated with an increase in spatial and frontal QRS-T angles in patients with anterior myocardial infarction

Factors associated with an increase in spatial and frontal QRS-T angles in patients with anterior myocardial infarction

The value of the spatial QRS–T angle for assessing the severity of heart damage in patients with arterial hypertension

Sustainability of spatial QRS-T angle of vectorcardiogram to filtration: a pilot study

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