Risk Factors Of Frontal QRS-T Angle Widening And Its Correlation With Cardiovascular Death In General Population In Rural Areas Of Northeast China

Obstructive:The frontal QRS-T angle is a simple indicator that can be obtained by a 12-lead ECG.The wide frontal QRS-T angle can predict that all-cause death has been confirmed.The prediction of cardiovascular death in the Chinese population has not been reported.The purpose of this study was: 1)to investigate the determinant factors of the frontal QRS-T angle widening,and 2)to proof the predictive effect of frontal QRS-T angle on cardiovascular mortality in general population.Methods:The general population of this study was from the “ Northeast China Rural Cardiovascular Health Study ” starting from January 2013 to August 2013.A total of 10 912 people were enrolled in the cohort,with an average follow-up of 54.84±7.13 months.A 12-lead ECG was performed during the baseline survey to calculate the value of the frontal QRS-T angle,defining < 100° as normal and ? 100° as abnormal.The endpoint was cardiovascular death.Results:The baseline ECG frontal QRS-T angle ? 100° accounted for 2.7% of the population.Stepwise regression analysis using binary logistic regression revealed an increase in serum calcium(OR 0.80,95% CI: 0.72-0.89;p < 0.001),BMI increase(OR 0.77,95% CI: 0.64-0.92;p 0.005),elevated left ventricular ejection fraction(OR 0.25,95% CI: 0.11-0.55;p 0.001)are protective factors for the increase of the angle of the frontal QRS-T angle,and e GFR decreases(OR 1.67,95% CI: 1.37-2.04);p < 0.001),increased grade of hypertension(OR 1.21,95% CI: 1.07-1.37;p 0.003),increased left ventricular mass index(OR 1.46,95% CI: 1.11-1.92;p 0.007),QTc prolongation(OR 2.03,95% CI: 1.56-2.64;p < 0.001),left ventricular high voltage(OR 2.42,95% CI: 1.88-3.12;p < 0.001),atrial fibrillation(OR 8.42,95% CI: 4.51-15.69;p < 0.001)and Myocardial infarction(OR 2.61,95% CI: 1.36-5.03;p 0.004)are risk factors for the wide frontal QRS-T angle.The cumulative cardiovascular mortality rate of the cohort was 1.9%.The group of frontal QRS-T angle ? 100° died 28 people(9.7%,95% CI: 6.2%-13.1%),the average survival time was 52.43±12.58 months,and the group of frontal QRS-T angle < 100° died 182 people(1.7 %,95% CI: 1.5%-2.0%),mean survival time was 54.91±6.91 months,log-rank test showed significant difference in survival curve(p <0.001).After adjusting for COX regression,the risk of cardiovascular death was higher in the abnormal frontal QRS-T angle group than in the normal group(HR 2.02,95% CI: 1.28-3.19;p 0.003).Conclusion:1)Increased serum calcium,increased BMI and increased left ventricular ejection fraction are protective factors for the widening of the frontal QRS-T angle.Decreased e GFR,increased grade of hypertension,increased left ventricular mass index,left ventricular high voltage,atrial fibrillation,and myocardial infarction are risk factors for widening the frontal QRS-T angle;2)wide frontal QRST angle increase the risk of cardiovascular mortality.