Prognostic value of frontal QRS-T angle in predicting survival after primary percutaneous coronary revascularization/coronary artery bypass grafting for ST-elevation myocardial infarction

Sawant, Abhishek C.; Bhardwaj, Aishwarya; Srivatsa, Shantanu; Sridhara, Srilekha; Prakash, Meghana Prakash Hiriyur; Kanwar, Nidhi; Rodriguez, Janelle; Tse, Gary M.; Liu, Tong; Kumar, Arnav; Beck, Hiroko; Srivatsa, Sanjay S.

doi:10.1016/j.ihj.2019.09.008

Cited by 9 publications

(13 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The fQRSTa more than 90° was found to be an independent predictor of death, appropriate implantable cardioverter‐defibrillator shock, or resuscitated cardiac arrest in nonpaced patients with nonischemic cardiomyopathy 23 . Two hundred sixty‐seven patients with ST segment elevation myocardial infarction (STEMI) were evaluated by Sawant et al 24 and those who had wider fQRSTa had 2.04 times more mortality rates. A study by Dogan et al 25 including 340 patients with STEMI found fQRSTa to be related with coronary atherosclerotic burden.…”

Section: Discussionmentioning

confidence: 99%

The prognostic value of fQRSTa in patients with aortic stenosis undergoing surgical aortic valve replacement

et al. 2020

View full text Add to dashboard Cite

Background Surgical aortic valve replacement (sAVR) is the ultimate therapy for severe aortic stenosis (AS) in suitable patients. Prognostic factors of sAVR are great interest in recent studies. Frontal QRS‐T angle (fQRSTa) is a novel marker of ventricular repolarization abnormalities. In this study, we aimed to investigate the prognostic value of fQRSTa in patients with severe symptomatic AS undergoing sAVR. Methods A total of 372 patients with severe degenerative AS who underwent successful sAVR were included in this retrospective study. Then, patients were divided into two groups: patients with narrow fQRSTa (≤90°) as group 1 and wide fQRSTa (>90°) as group 2. Perioperative and postoperative clinical evaluation and time of death were recorded from all subjects. Results The incidence of total mortality was higher in patients with wider fQRSTa (13.8% [15]; 4.9% [9], P = .013) compared to patients with narrow fQRSTa. In multivariate logistic regression analysis, advanced age (odds ratio [OR] = 1.054; 95% confidence interval [CI] = 1.004‐1.106; P = .034), dyspnea (OR = 7.687; 95% CI = 2.296‐25.729; P = .001), lower efection fraction (OR = 0.924; 95% CI = 0.884‐0.966; P = .001), in‐hospital duration (OR = 1.051; 95% CI = 1.016‐1.088; P = .004) and wider fQRSTa (OR = 4.029; 95% CI = 1.383‐11.740; P = .011) were found to be independent predictors of mortality. Additionally, a Kaplan‐Meier survival analysis also revealed that long‐term survival was found to be significantly decreased in patients with wider fQRSTa (log‐rank P = .014). Conclusion fQRSTa was related with poor prognosis in patients with AS undergoing sAVR. fQRSTa was also an independent predictor of mortality in this population.

show abstract

Section: Discussionmentioning

confidence: 99%

The prognostic value of fQRSTa in patients with aortic stenosis undergoing surgical aortic valve replacement

et al. 2020

View full text Add to dashboard Cite

show abstract

“…По данным других авторов, больные с ОКС или ИМ с увеличением fQRS-T по сравнению с меньшим fQRS-T были старше [5][6][7][8], у них чаще встречались перенесенный ИМ [5,6,8], сердечная недостаточность [5,7,8], снижение ФВ ЛЖ [4,7]. Отмечалось более частое наличие многососудистого поражения [5] и поражение ствола левой коронарной артерии [7]. Кроме того, у больных с увеличением fQRS-T ИМбпST развивался чаще, чем ИМпST [7,8].…”

Section: Discussionunclassified

“…В ряде исследований продемонстрирована роль fQRS-T как диагностического критерия при подозрении на ИМ, независимого прогностического критерия кардиальной и общей смертности в раннем и отдаленном периодах у больных с острым ИМ с подъемом сегмента ST (ИМпST) и без подъема сегмента ST (ИМбпST), что значительно повысило интерес к fQRS-T и sQRS-T в настоящее время [4][5][6][7][8].…”

Section: оригинальные статьи §unclassified

“…У пациентов с ИМпST, перенесших ЧКВ или коронарное шунтирование, fQRS-T являлся независимым предиктором смерти в течение года, а также был связан с большей продолжительностью пребывания в стационаре [5].…”

Section: оригинальные статьи §unclassified

See 1 more Smart Citation

Factors Associated with the Increase in Spatial and Frontal QRS-T Angles in Patients with Inferior Myocardial Infarction

et al. 2020

View full text Add to dashboard Cite

Aim To identify clinical, echocardiographic, and angiographic factors related with an increase in the frontal QRS-T angle (fQRS-T) and the spatial QRS-T angle (sQRS-T) in patients with inferior myocardial infarction.Material and methods The study included 128 patients aged (median [25th percentile; 75th percentile]) 59.5 [51.5; 67.0] years diagnosed with inferior wall acute myocardial infarction. fQRS-T was calculated as a module of difference between the QRS axis and the Т axis in the frontal plane. sQRS-T was calculated by a synthesized vectorcardiogram as a spatial angle between the QRS and Т integral vectors.Results The fQRS-T for the group was 54.0 [18; 80] and sQRS-T was 80.1 [53; 110]. The correlation coefficient for fQRS-T and sQRS-T values was 0.42 (p<0.001). Both fQRS-T >80° and sQRS-T >110° compared to their lower values were associated with a higher frequency of history of postinfarction cardiosclerosis (44% and 12 %, respectively; p<0.05), a lower left ventricular ejection fraction (51 [47; 60]% at fQRS-T >80° and 55 [50; 60]% at fQRS-T <80° (p<0,05); 49 [44; 57]% at sQRS-T >110° and 57 [51; 60] % at sQRS-T <110° (p<0.01); more frequent development of acute heart failure (16 and 2 %, respectively; p<0.05); and early postinfarction angina (13 and 2 %, respectively; p<0.05). The increased fQRS-T was associated with a higher incidence of damage to the circumflex artery (45 and 20 %, respectively; p<0.05). The increased sQRS-T was associated with a history of arterial hypertension (97 and 76 %, respectively; p<0.05), chronic heart failure (22 and 3 %, respectively; p<0.05), chronic kidney disease (19 and 4 %, respectively; p<0.05), and a larger myocardial lesion (mean number of damaged segments by echocardiography was 3.8 [2; 6] at sQRS-T >110° and 2.6 [1; 4] at sQRS-T <110°; p<0.01). sQRS-T was significantly greater in multivascular damage (87 [68; 121]° than in one- or two-vascular damage (72 [51; 100]°; p<0.05). sQRS-T values were significantly lower with spontaneous reperfusion (66 [29; 79] than without spontaneous reperfusion (77 [55; 115]°; p<0.05).Conclusion In patients after inferior wall acute myocardial infarction, increases in fQRS-T and sQRS-T were associated with more severe damage of coronary vasculature, decreased left ventricular ejection fraction, and more severe course of disease.

show abstract

“…9,10 Importantly, as a sign of instability in the myocardial conduction system, increased fQRST angle, particularly an angle >90°, is a predictor of arrhythmic substrates and is significantly associated with arrhythmic events and mortality in a wide variety of patients with cardiovascular diseases. 11,19,20 Besides the P wave indices, ventricular depolarization and repolarization abnormalities also seem to be associated with atrial electrophysiological abnormalities, occurrence of atrial arrhythmias and Af. [21][22][23] Moreover, a significant association between abnormal fQRST angle and emergence of Af has been reported.…”

Section: Ta B L E 1 Clinical and Electrocardiographic Characteristics Of Patient Groupsmentioning

confidence: 99%

Frontal plane QRS‐T angle predicts early recurrence of acute atrial fibrillation after successful pharmacological cardioversion with intravenous amiodarone

Eyuboglu

Çelik

2021

J Clin Pharm Ther

View full text Add to dashboard Cite

What is known and Objective: Although restoration of sinus rhythm is the integral part of the atrial fibrillation (Af) management, recurrence frequency of Af is high after cardioversion. However, little is known about the association of electrocardiography (ECG) parameters with Af recurrence after restoration of sinus rhythm. The present study aimed to investigate whether frontal plane QRS-T (fQRST) angle, as a marker of ventricular repolarization heterogeneity, predicts Af recurrence after successful pharmacological cardioversion.Methods: One hundred and sixty-five paroxysmal Af patients with an acute Af episode who underwent successful pharmacological cardioversion with intravenous amiodarone infusion were included into the study. Patients were divided into two groups according to presence or absence of in-hospital Af recurrence. The association between fQRST angle and Af recurrence was investigated.Results and discussion: Af recurrence was observed in 42 (25.4%) patients. The mean fQRST angle was significantly higher in patients with Af recurrence compared to those without Af recurrence (90 ± 45.8 vs. 51 ± 38.2, p < 0.001). Also, Af recurrence was more frequent in patients who had fQRST angle >90˚, compared to patients with fQRST angle ≤90˚ (54.1% vs. 13.7%, p < 0.001). Moreover, ROC curve analysis demonstrated that an increased fQRST angle >92.5˚ predicted in-hospital Af recurrence with a sensitivity of 76.2% and a specificity of 81.4% (AUC:0.728, p < 0.001).Furthermore, multivariate analysis demonstrated that fQRST angle was an independent predictor of in-hospital Af recurrence after successful pharmacological cardioversion (OR: 1.892, 95% CI: 1.361-2.917, p < 0.001). What is new and conclusion:As a parameter that can be easily calculated from automated ECG recordings, fQRST angle may be useful in the prediction of early Af recurrence after successful pharmacological cardioversion with amiodarone.

show abstract

Prognostic value of frontal QRS-T angle in predicting survival after primary percutaneous coronary revascularization/coronary artery bypass grafting for ST-elevation myocardial infarction

Cited by 9 publications

References 24 publications

The prognostic value of fQRSTa in patients with aortic stenosis undergoing surgical aortic valve replacement

The prognostic value of fQRSTa in patients with aortic stenosis undergoing surgical aortic valve replacement

Factors Associated with the Increase in Spatial and Frontal QRS-T Angles in Patients with Inferior Myocardial Infarction

Frontal plane QRS‐T angle predicts early recurrence of acute atrial fibrillation after successful pharmacological cardioversion with intravenous amiodarone

Contact Info

Product

Resources

About