Widening of the electrocardiographic (ECG) spatial QRS-T angle has been predictive of cardiovascular disease (CVD) events in the general population. However, its prognostic significance in human immunodeficiency virus (HIV)-infected patients remains unknown. The spatial QRS-T angle was derived from the baseline resting 12-lead electrocardiogram of 4,453 HIV-infected patients aged 43.5 ± 9.3 years from the Strategies for Management of Antiretroviral Therapy (SMART) trial. CVD events were identified during a median follow-up of 28.7 months. Quartiles of the spatial QRS-T angle was calculated for men and women separately, and values in the upper quartile were considered as a widened angle (values >74° for women and >93° for men). A multivariate Cox proportional hazards analysis was used to examine the association between a widened baseline spatial QRS-T angle and incident CVD events. During 11,965 person-years of follow-up, 152 CVD events occurred at a rate of 1.27 events/100 person-years. The rate of CVD events in those with a widened spatial QRS-T angle was almost double the rate in those with a normal spatial QRS-T angle (rate ratio 1.94, 95% confidence interval 1.40 to 2.69; p <0.001). In a model adjusted for study treatment arm, demographics, CVD risk factors, HIV characteristics, inflammatory markers, and other ECG abnormalities, a widened spatial QRS-T angle was associated with a >50% increased risk of CVD events compared to a normal spatial QRS-T angle (hazard ratio 1.53, 95% confidence interval 1.07 to 2.17; p = 0.02). No interaction was seen by SMART trial arm (p value for interaction = 0.37) or gender (p value for interaction = 0.84). In conclusion, a widened spatial QRS-T angle was independently predictive of CVD events in HIV-infected patients receiving antiretroviral therapy. This highlights the potential role of routine electrocardiography as a simple noninvasive CVD risk-screening tool in HIV-infected patients.
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http://dx.doi.org/10.1016/j.amjcard.2012.08.054 | DOI Listing |
JACC Adv
December 2024
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, New York, USA.
Background: The Hispanic/Latino population is not uniform. Prevalence and clinical outcomes of cardiac arrhythmias in ethnic background subgroups are variable, but the reasons for differences are unclear. Vectorcardiographic Global Electrical Heterogeneity (GEH) has been shown to be associated with adverse cardiovascular outcomes.
View Article and Find Full Text PDFJ Electrocardiol
December 2024
Crown Princess Victoria Children's Hospital, Dept of Biomedical and Clinical Sciences, Dept of Pediatrics, Linköping University, Sweden; Pediatric Heart Centre, Skåne University Hospital and Dept of Clinical Sciences, Lund University, Sweden. Electronic address:
Background: Myocardial fibrosis, expressed as late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR), is an important risk factor for malignant cardiac events in hypertrophic cardiomyopathy (HCM). However, CMR is not easily available, expensive, also needing intravenous access and contrast.
Objective: To determine if derived vectorcardiographic spatial QRS-T angles, an aspect of advanced ECG (A-ECG), can indicate LGE to appropriately prioritize young HCM-patients for CMR.
BMC Cardiovasc Disord
November 2024
Cardiovascular Medicine Department, Cardiology Center, First Hospital of Jilin University, No.1 Xinmin Street, Changchun City, 130021, Jilin Province, China.
Background: Sex is a determinant of the incidence and etiology of arrhythmia. Observational and basic studies suggest that sex hormones are essential in this process; however, the relationship between sex hormones and arrhythmia remains unclear. Mendelian randomization (MR) was used to investigate the causal relationships between sex hormone levels, arrhythmia, and electrocardiographic (ECG) indices.
View Article and Find Full Text PDFEur Heart J Digit Health
September 2024
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY, USA.
Aims: Despite the highest prevalence of stroke, obesity, and diabetes across races/ethnicities, paradoxically, Hispanic/Latino populations have the lowest prevalence of atrial fibrillation and major Minnesota code-defined ECG abnormalities. We aimed to use Latent Profile Analysis in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) population to obtain insight into epidemiological discrepancies.
Methods And Results: We conducted a cross-sectional analysis of baseline HCHS/SOL visit.
J Electrocardiol
August 2024
Department of Pediatrics, University of California at Davis Health, Sacramento, CA, United States of America; Division of Pediatric Cardiology, University of California at Davis Health, Sacramento, CA, United States of America. Electronic address:
Background: Limited data exists on interpreting vectorcardiography (VCG) parameters in the Fontan population.
Objective: The purpose of this study was to demonstrate the associations between ECG/VCG parameters and Fontan failure (FF).
Methods/results: 107 patients with a Fontan operation after 1990 and without significant ventricular pacing were included.
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