Borderline Q-waves in individuals without overt cardiovascular disease: relations with adiposity, subclinical atherosclerosis and vascular stiffness

Elffers, T.W., Trompet, S., de Mutsert, R., Maan, A.C., Lamb, H.J., Macfarlane, P.W., Rosendaal, F.R. and Jukema, J.W. (2019) Borderline Q-waves in individuals without overt cardiovascular disease: relations with adiposity, subclinical atherosclerosis and vascular stiffness. International Journal of Cardiology, 274, pp. 331-336. (doi: 10.1016/j.ijcard.2018.08.088) (PMID:30195838)

Abstract

Background: Characteristics and risk factors associated with electrocardiographic borderline Q-waves are not fully elucidated, especially in individuals without overt cardiovascular disease (CVD). Also, the relation of isolated and non-isolated borderline Q-waves with subclinical atherosclerosis and vascular stiffness is unknown. Methods and results: We included 5746 Netherlands Epidemiology of Obesity study participants without overt CVD. Participants were divided in three groups: no Q-waves (93.7%), isolated (4.6%) and non-isolated borderline Q-waves (1.7%). Borderline Q-waves were defined as Minnesota Codes 1.2.x and 1.3.x and non-isolated as ≥1 of abnormal QRS axis, left ventricular hypertrophy or ST/T abnormalities. Several characteristics and measures of body fat were assessed. Vascular stiffness was assessed by pulse wave velocity (PWV) and subclinical atherosclerosis by carotid intima-media thickness (cIMT). Percentage of men, alcohol intake, blood pressure and fasting glucose concentrations were, compared with no Q-waves, higher in the isolated and highest in the non-isolated borderline Q-wave group. Isolated borderline Q-waves were associated with higher body mass index (difference compared with no Q-waves: 1.0 kg/m2; 95%CI: 0.3–1.7; p-value: 0.006), waist circumference (3.4 cm; 1.0–5.8; 0.005), and visceral adipose tissue (21.9 cm2; 7.4–36.3; 0.003) and differences were even larger for non-isolated borderline Q-waves. Compared with no Q-waves, non-isolated borderline Q-waves were associated with higher PWV (1.2 m/s; 0.4–2.0; 0.004) and cIMT (23.4 μm; 3.0–43.8; 0.024), whereas isolated borderline Q-waves were not. Conclusion: Cardiovascular risk factors and measures of body fat, especially abdominal adiposity, were higher in participants with isolated borderline Q-waves, compared with no Q-waves, and highest in the non-isolated borderline Q-wave group. Non-isolated borderline Q-waves were associated with subclinical atherosclerosis and vascular stiffness. Future studies should investigate potential added value of borderline Q-waves in CVD prediction.

• Item Type: Articles
• Additional Information: This work was supported by the participating Departments; the Division and the Board of Directors of the Leiden University Medical Centre, and by the Leiden University, Research Profile Area ‘Vascular and Regenerative Medicine’.
• Keywords: Borderline Q-waves, subclinical atherosclerosis, vascular stiffness.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Macfarlane, Professor Peter
• Authors: Elffers, T.W., Trompet, S., de Mutsert, R., Maan, A.C., Lamb, H.J., Macfarlane, P.W., Rosendaal, F.R., and Jukema, J.W.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: International Journal of Cardiology
• Publisher: Elsevier
• ISSN: 0167-5273
• ISSN (Online): 1874-1754
• Published Online: 01 September 2018
• Copyright Holders: Copyright © 2018 The Authors
• First Published: First published in International Journal of Cardiology 274: 331-336
• Publisher Policy: Reproduced under a Creative Commons License