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

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 guideline...

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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
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description 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
doi_str_mv 10.1016/j.amjcard.2005.08.052
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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 &lt;0.001 and −0.135 ± 0.665 vs −0.657 ± 0.518 for TCRT, p &lt;0.001, alive vs cardiac death, respectively). After adjustment for clinical risk markers in the Cox regression analysis, TWLD still significantly predicted for cardiac mortality (p &lt;0.05); however, TCRT had lost its predictive power. TWLD did not have significant univariate or multivariate association with noncardiac mortality. In conclusion, TWLD that describes the shape of the T-wave loop is a specific predictor of cardiac death and independent of the clinical risk markers in the current treatment era of patients with AMI.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2005.08.052</identifier><identifier>PMID: 16442395</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Biological and medical sciences ; Cardiology ; Cardiology. 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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
title Usefulness of T-Wave Loop and QRS Complex Loop to Predict Mortality After Acute Myocardial Infarction
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