Spatial QRS-T angle and cognitive decline in older subjects

Mahinrad, S. et al. (2019) Spatial QRS-T angle and cognitive decline in older subjects. Journal of Alzheimer's Disease, 67(1), pp. 279-289. (doi: 10.3233/JAD-180633) (PMID:30584139)

180407.pdf - Accepted Version



Background:An abnormally wide spatial QRS-T angle on an ECG is a marker of heterogeneity in electrical activity of cardiac ventricles and is linked with cardiovascular events. Growing evidence suggests that cardiac dysfunction might signal future cognitive decline. Objective: In this study, we investigated whether spatial QRS-T angle associates with future cognitive decline in older subjects at high cardiovascular risk. Methods:We included 4,172 men and women (mean age 75.2±3.3 years) free of cardiac arrhythmias from the PROSPER cohort. Spatial QRS-T angle was calculated from baseline 12-lead ECGs using a matrix transformation method. Cognitive function was assessed using 4 neuropsychological tests including Stroop test, letter-digit coding test, immediate and delayed picture word learning tests. Cognitive function was assessed at baseline and repeatedly during a mean follow-up time of 3.2 years. Using linear mixed models, we calculated the annual changes of cognitive scores in sex-specific thirds of spatial QRS-T angle. Results:Participants with wider spatial QRS-T angle had a steeper decline in letter-digit coding test (β= –0.0106, p = 0.004), immediate picture-word learning test (β= –0.0049, p = 0.001), and delayed picture-word learning test (β= –0.0055, p = 0.013). All associations were independent of arrhythmias, cardiovascular risk factors, comorbidities, medication use, cardiovascular events, and other ECG abnormalities including QRS duration, QTc interval, T wave abnormalities, and left ventricular hypertrophy. Conclusion:Abnormal cardiac electrical activity characterized by wide spatial QRS-T angle associates with accelerated cognitive decline independent of conventional cardiovascular factors. These findings suggest a link between a non-traditional ECG measure of pre-clinical cardiac pathology and future cognitive decline.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Macfarlane, Professor Peter and Stott J, Professor David and Clark, Mrs Elaine and Ford, Professor Ian
Authors: Mahinrad, S., Ferguson, I., Macfarlane, P. W., Clark, E. N., Stott, D. J., Ford, I., Mooijaart, S. P., Trompet, S., van Heemst, D., Jukema, J. W., Sabayan, B., and Ikram, M. A.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
Journal Name:Journal of Alzheimer's Disease
Publisher:IOS Press
ISSN (Online):1875-8908
Copyright Holders:Copyright © 2019 IOS Press and the Authors
First Published:First published in Journal of Alzheimer's Disease 67(1): 279-289
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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