Document Detail


Abnormal spatial QRS-T angle predicts mortality in patients undergoing dobutamine stress echocardiography for suspected coronary artery disease.
MedLine Citation:
PMID:  19996961     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the association between (cardiac) mortality and spatial QRS-T angle in patients undergoing dobutamine - atropine stress echocardiography (DSE) for evaluation of known or suspected coronary disease. METHODS: Between 1990 and 2003, 2347 patients underwent DSE for evaluation of coronary disease at the Erasmus Medical Center. Echocardiographic images were analyzed offline using a 16-segment, 5-point scoring model for regional function. Twelve-lead resting ECGs were analyzed and patients were grouped in three categories according to their spatial QRS-T angle: normal (0-105 degrees), borderline (105-135 degrees), and abnormal (135-180 degrees). RESULTS: Mean age was 61+/-13 years, 66% were male, 32% had hypertension, 26% had hypercholesterolemia, 28% were smokers, and 12% were diabetic. During a mean follow-up of 7+/-3.4 years, 26.5% (623) of the patients died; 15.3% (359) died due to a cardiac cause. Abnormal QRS-T angle (135-180 degrees ) was present in 21% of the patients. Abnormal QRS-T angle was a predictor of cardiac death [hazard ratio: 3.2 (2.6-4.1)] and all-cause mortality [hazard ratio: 2.2 (1.8-2.6)]. After multivariate analysis abnormal and borderline QRS-T angle, peak wall motion score, age, male sex, history of diabetes, history of heart failure, smoking, and hypertension were independent predictors of (cardiac) death. CONCLUSION: Abnormal QRS-T angle is an independent predictor of (cardiac) death in patients undergoing DSE. Abnormal QRS-T angle should be considered as a risk factor in stable patients evaluated for coronary disease.
Authors:
Jonathan A Lipton; Stefan P Nelwan; Ron T van Domburg; Jan A Kors; Abdou Elhendy; Arend F L Schinkel; Don Poldermans
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Coronary artery disease     Volume:  21     ISSN:  1473-5830     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-22     Completed Date:  2010-03-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  26-32     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands. j.lipton@erasmusmc.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Artery Disease / mortality*,  physiopathology,  ultrasonography*
Echocardiography, Stress*
Electrocardiography
Female
Hemodynamics
Humans
Logistic Models
Male
Middle Aged
Predictive Value of Tests
Prognosis
Risk Assessment
Risk Factors
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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