Journal
JOURNAL OF ELECTROCARDIOLOGY
Volume 43, Issue 4, Pages 310-317Publisher
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.jelectrocard.2010.05.004
Keywords
Ventricular repolarization; Cardiovascular death; Sudden death; Prognosis; Myocardial infarction
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Funding
- Swedish Heart-Lung Foundation
- Latvian Society of Cardiology
- Sahlgrenska University Hospital
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Reliable cardiovascular (CV) risk assessment by a noninvasive tool would be of great value for CV event prevention. The present study consists of 187 coronary artery disease patients with 8 years of follow-up. Eight vectorcardiographic parameters characterizing different aspects of ventricular repolarization were analyzed at baseline: (1) the ST-segment (ST-VM), (2) the T vector angles (QRS-T angle, Televation, and Tazimuth), (3) the T vector loop morphology (Tavplan and Teigenvalue), and (4) Tarea and Tpeak-end. Cardiovascular death, myocardial infarction (MI), and repeated revascularization were traced via national registries. There were 16 CV deaths and 19 Mls; 89 patients remained free from CV events and revascularization. Ventricular repolarization parameters independently predicted CV death (widened QRS-T angle) and new MI (increased Tavplan) during follow-up. CV mortality was associated with increased divergence between depolarization and repolarization waves (widened QRS-T angle). Increased Tavplan, presumably reflecting heterogeneous repolarization, predicted future MI, which is a novel finding. (C) 2010 Elsevier Inc. All rights reserved.
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