Frontal Plane QRS – T Angle Is a Predictor of Ventricular Arrhythmia in Heart Failure With Preserved Ejection Fraction

ABSTRACT Introduction Various ventricular repolarization parameters are known to predict ventricular arrhythmias and mortality in various diseases. Although mortality in patients with heart failure with preserved ejection fraction (HFpEF) is similar to that in heart failure with reduced ejection fra...

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Main Authors: Çağrı Zorlu, Barış Açıkel, Sefa Erdi Ömür
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Annals of Noninvasive Electrocardiology
Subjects:
Online Access:https://doi.org/10.1111/anec.70062
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author Çağrı Zorlu
Barış Açıkel
Sefa Erdi Ömür
author_facet Çağrı Zorlu
Barış Açıkel
Sefa Erdi Ömür
author_sort Çağrı Zorlu
collection DOAJ
description ABSTRACT Introduction Various ventricular repolarization parameters are known to predict ventricular arrhythmias and mortality in various diseases. Although mortality in patients with heart failure with preserved ejection fraction (HFpEF) is similar to that in heart failure with reduced ejection fraction patients, studies on this subject are more limited. Therefore, it is important to evaluate the relationship between ventricular arrhythmias and mortality and ventricular repolarization parameters, especially the frontal plane QRS–T angle, in patients with HFpEF. Methods Electrocardiographic, echocardiographic, and laboratory data of 811 patients were evaluated, and the fQRST angle was calculated on ECG. The occurrence of ventricular tachycardia, ventricular fibrillation, or sudden death within a mean of 48 ± 12 months was recorded. Statistical significance was determined as p < 0.05. Results A total of 811 patients were evaluated, 180 patients in the cardiac event group and 631 patients in the no cardiac event group. NT‐proBNP, La size, La volume index, Tp‐e time, Tp‐e/QTc ratio, and fQRS‐T angle were statistically significantly higher in the cardiac event group. NT‐proBNP level and fQRS‐T angle were found to be independent predictors of mortality in multivariate cox analysis. According to ROC analysis, when QRS‐T angle has a cut‐off value of 58.63, its sensitivity is 81.2, and its specificity is 79.3. Kaplan‐Meier analysis also found that when the fQRS‐T angle was > 58.63, mortality was higher than at narrower angles. Conclusions According to our study, the fQRS‐T angle, which can be easily and inexpensively calculated on ECG, predicts long‐term ventricular arrhythmias in patients with HFpEF.
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series Annals of Noninvasive Electrocardiology
spelling doaj-art-203c68a3e8744df19018deddd7a8bb2c2025-08-20T03:44:24ZengWileyAnnals of Noninvasive Electrocardiology1082-720X1542-474X2025-03-01302n/an/a10.1111/anec.70062Frontal Plane QRS – T Angle Is a Predictor of Ventricular Arrhythmia in Heart Failure With Preserved Ejection FractionÇağrı Zorlu0Barış Açıkel1Sefa Erdi Ömür2Department of Cardiology Tokat Gaziosmanpasa University Hospital Tokat TurkeyDepartment of Cardiology Tokat State Hospital Toakt TurkeyDepartment of Cardiology Tokat Gaziosmanpasa University Hospital Tokat TurkeyABSTRACT Introduction Various ventricular repolarization parameters are known to predict ventricular arrhythmias and mortality in various diseases. Although mortality in patients with heart failure with preserved ejection fraction (HFpEF) is similar to that in heart failure with reduced ejection fraction patients, studies on this subject are more limited. Therefore, it is important to evaluate the relationship between ventricular arrhythmias and mortality and ventricular repolarization parameters, especially the frontal plane QRS–T angle, in patients with HFpEF. Methods Electrocardiographic, echocardiographic, and laboratory data of 811 patients were evaluated, and the fQRST angle was calculated on ECG. The occurrence of ventricular tachycardia, ventricular fibrillation, or sudden death within a mean of 48 ± 12 months was recorded. Statistical significance was determined as p < 0.05. Results A total of 811 patients were evaluated, 180 patients in the cardiac event group and 631 patients in the no cardiac event group. NT‐proBNP, La size, La volume index, Tp‐e time, Tp‐e/QTc ratio, and fQRS‐T angle were statistically significantly higher in the cardiac event group. NT‐proBNP level and fQRS‐T angle were found to be independent predictors of mortality in multivariate cox analysis. According to ROC analysis, when QRS‐T angle has a cut‐off value of 58.63, its sensitivity is 81.2, and its specificity is 79.3. Kaplan‐Meier analysis also found that when the fQRS‐T angle was > 58.63, mortality was higher than at narrower angles. Conclusions According to our study, the fQRS‐T angle, which can be easily and inexpensively calculated on ECG, predicts long‐term ventricular arrhythmias in patients with HFpEF.https://doi.org/10.1111/anec.70062echocardiography/methodselectrocardiography/methodsfrontal plane QRSheart failure with preserved ejection fractionmortalityventricular arrhythmias
spellingShingle Çağrı Zorlu
Barış Açıkel
Sefa Erdi Ömür
Frontal Plane QRS – T Angle Is a Predictor of Ventricular Arrhythmia in Heart Failure With Preserved Ejection Fraction
Annals of Noninvasive Electrocardiology
echocardiography/methods
electrocardiography/methods
frontal plane QRS
heart failure with preserved ejection fraction
mortality
ventricular arrhythmias
title Frontal Plane QRS – T Angle Is a Predictor of Ventricular Arrhythmia in Heart Failure With Preserved Ejection Fraction
title_full Frontal Plane QRS – T Angle Is a Predictor of Ventricular Arrhythmia in Heart Failure With Preserved Ejection Fraction
title_fullStr Frontal Plane QRS – T Angle Is a Predictor of Ventricular Arrhythmia in Heart Failure With Preserved Ejection Fraction
title_full_unstemmed Frontal Plane QRS – T Angle Is a Predictor of Ventricular Arrhythmia in Heart Failure With Preserved Ejection Fraction
title_short Frontal Plane QRS – T Angle Is a Predictor of Ventricular Arrhythmia in Heart Failure With Preserved Ejection Fraction
title_sort frontal plane qrs t angle is a predictor of ventricular arrhythmia in heart failure with preserved ejection fraction
topic echocardiography/methods
electrocardiography/methods
frontal plane QRS
heart failure with preserved ejection fraction
mortality
ventricular arrhythmias
url https://doi.org/10.1111/anec.70062
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AT barısacıkel frontalplaneqrstangleisapredictorofventriculararrhythmiainheartfailurewithpreservedejectionfraction
AT sefaerdiomur frontalplaneqrstangleisapredictorofventriculararrhythmiainheartfailurewithpreservedejectionfraction