Prediction of cardiovascular death and myocardial infarction by the QRS-T angle and T vector loop morphology after angioplasty in stable angina pectoris: an 8-year follow-up☆☆☆

Abstract 

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 MIs; 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.

Keywords: Ventricular repolarization, Cardiovascular death, Sudden death, Prognosis, Myocardial infarction