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Temporal changes in electrocardiographic frontal QRS-T angle and survival in patients with heart failure

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  • Israel Gotsman
  • Ayelet Shauer
  • Yair Elizur
  • Donna R Zwas
  • Chaim Lotan
  • Andre Keren

Abstract

Background: Heart failure (HF) is associated with considerable mortality. The electrocardiographic frontal QRS-T angle is a simple parameter to measure, reflects changes in the direction of the repolarization sequence and predicts outcome in patients with HF. Data regarding temporal changes in the frontal QRS-T angle in patients with HF and its impact on outcome is limited. Aim: To evaluate temporal changes in the frontal QRS-T angle and its effect on survival in patients with HF. Methods: Baseline and follow-up QRS-T angle were calculated from the frontal QRS and T axis of the 12-lead surface electrocardiogram. Patients were followed for survival. Results: 2,929 HF patients were evaluated. Median interval between baseline ECG and follow-up ECG was 895 days, median follow-up time was 1526 days. Overall, the QRS-T angle tended to be stable, with minor changes in the angle over time. The median QRS-T angle change was +3° (IQR -19° to +30°). Overall survival during follow-up was 60%. Cox regression analysis after adjustment for significant predictors demonstrated that the QRS-T angle was an incremental predictor of increased mortality. A widening of the QRS-T angle during follow-up was independently associated with an increase in mortality, evident with an increase of the QRS-T angle difference above 0° (P

Suggested Citation

  • Israel Gotsman & Ayelet Shauer & Yair Elizur & Donna R Zwas & Chaim Lotan & Andre Keren, 2018. "Temporal changes in electrocardiographic frontal QRS-T angle and survival in patients with heart failure," PLOS ONE, Public Library of Science, vol. 13(3), pages 1-10, March.
    • Handle: RePEc:plo:pone00:0194520
    DOI: 10.1371/journal.pone.0194520
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    References listed on IDEAS

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    1. Israel Gotsman & Donna Zwas & Chaim Lotan & Andre Keren, 2012. "Heart Failure and Preserved Left Ventricular Function: Long Term Clinical Outcome," PLOS ONE, Public Library of Science, vol. 7(7), pages 1-6, July.
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