Usefulness of T-Wave Loop and QRS Complex Loop to Predict Mortality After Acute Myocardial Infarction

• Published in: The American journal of cardiology 2006-02, Vol.97 (3), p.353-360
• Main Authors: Perkiömäki, Juha S., Hyytinen-Oinas, Miia, Karsikas, Mari, Seppänen, Tapio, Hnatkova, Katerina, Malik, Marek, Huikuri, Heikki V.
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Coronary heart disease; Electrocardiography; Female; Follow-Up Studies; Heart; Heart attacks; Humans; Male; Medical research; Medical sciences; Middle Aged; Mortality; Myocardial Infarction - diagnosis; Myocardial Infarction - mortality; Myocardial Infarction - therapy; Myocarditis. Cardiomyopathies; Predictive Value of Tests; Risk
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2005.08.052

The aim of the study was to assess whether parameters based on the T-wave loop and QRS loop predict mortality, and cardiac mortality in particular, during follow-up of consecutive survivors of acute myocardial infarction (AMI). Patients with AMI (n = 437), treated according to contemporary guidelines, underwent digital high-resolution electrocardiography in orthogonal Frank leads (X, Y, Z) 5 to 14 days after AMI. Several T-wave and QRS loop parameters, such as the width and height of the loops and their ratio, T-wave loop dispersion (TWLD), QRS loop dispersion, and co-sine of the angle between the main vectors of the T-wave and QRS loops (TCRT), were calculated using a custom-made software package. During an average follow-up period of 43 ± 14 months, 53 patients (12%) died. Of these 53 deaths, 35 were cardiac. TWLD and TCRT were the T-wave loop/QRS loop parameters that best predicted for cardiac mortality on univariate comparison (35.4 ± 5.62 vs 32.8 ± 2.87 for TWLD, p