Frontal plane T-wave axis orientation predicts coronary events: Findings from the Moli-sani study

Iacoviello, L. et al. (2017) Frontal plane T-wave axis orientation predicts coronary events: Findings from the Moli-sani study. Atherosclerosis, 264, pp. 51-57. (doi: 10.1016/j.atherosclerosis.2017.07.021) (PMID:28772106)

Abstract

The orientation of the frontal plane T-wave axis (T axis) is a reliable measure of ventricular repolarisation. We investigated the association between T-axis and the risk of coronary heart disease (CHD), heart failure (HF), atrial fibrillation (AF), stroke and cardiovascular (CVD) mortality. A sample of 21,287 Moli-sani participants randomly recruited from the general adult (≥35 y) Italian population, free of CVD disease, were followed for a median of 4.4 years. T-axis was measured from a standard 12-lead resting ECG. After adjusting for CVD risk factors, subjects with abnormal T-axis showed an increase in the risk of both CHD (Hazard Ratio (HR) = 2.65; 95% CI = 1.67-4.21), HF (HR = 2.56; 1.80-3.63), AF (HR = 2.48; 1.56-3.94) and CVD mortality (HR = 2.83; 1.50-5.32). The association with CHD and HF, but not with AF or CVD death, remained significant after further adjustment for ECG abnormalities. Subjects with abnormal T-axis showed higher levels of subclinical inflammation, hs-troponin I and hs-NT-proBNP (p < 0.001 for all). However, further adjustment for troponin I and/or NT-proBNP determined a reduction of HRs ranging from 12.1 to 24.0% for CHD, while additional adjustment for inflammation markers did not change any association. An abnormal T-axis orientation is associated with an increased risk of both CHD and HF, independently of common CVD risk factors and other ECG abnormalities. This association was partially explained by increased hs-troponin I and hs-NT-proBNP levels.

• Item Type: Articles
• Keywords: Cardiovascular disease, ECG, heart failure, population study, T-wave axis, ventricular repolarisation.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Macfarlane, Professor Peter
• Authors: Iacoviello, L., Bonaccio, M., Di Castelnuovo, A., Costanzo, S., Rago, L., De Curtis, A., Assanelli, D., Badilini, F., Vaglio, M., Persichillo, M., Macfarlane, P. W., Cerletti, C., Donati, M. B., and de Gaetano, G.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: Atherosclerosis
• Publisher: Elsevier
• ISSN: 0021-9150
• ISSN (Online): 1879-1484
• Published Online: 22 July 2017
• Copyright Holders: Copyright © 2017 Elsevier B.V.
• First Published: First published in Atherosclerosis 264:51-57
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher