Department of Cardiology, Leiden University Medical Center, 2300RC Leiden, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, 2300RC Leiden, the Netherlands.
Department of Cardiology, Leiden University Medical Center, 2300RC Leiden, the Netherlands; Department of Gerontology and Geriatrics, Leiden University Medical Center, 2300RC Leiden, the Netherlands.
Int J Cardiol. 2019 Jan 1;274:331-336. doi: 10.1016/j.ijcard.2018.08.088. Epub 2018 Sep 1.
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.
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/m; 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 cm; 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.
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.
与心电图边界 Q 波相关的特征和危险因素尚未完全阐明，尤其是在没有明显心血管疾病 (CVD) 的个体中。此外，孤立的和非孤立的边界 Q 波与亚临床动脉粥样硬化和血管僵硬的关系尚不清楚。
我们纳入了 5746 名无明显 CVD 的荷兰肥胖症流行病学研究参与者。参与者被分为三组：无 Q 波（93.7%）、孤立（4.6%）和非孤立边界 Q 波（1.7%）。边界 Q 波定义为明尼苏达州编码 1.2.x 和 1.3.x，非孤立为异常 QRS 轴、左心室肥厚或 ST/T 异常中的≥1 种。评估了几种身体脂肪特征和指标。通过脉搏波速度 (PWV) 评估血管僵硬，通过颈动脉内膜中层厚度 (cIMT) 评估亚临床动脉粥样硬化。与无 Q 波组相比，孤立和非孤立边界 Q 波组的男性百分比、饮酒量、血压和空腹血糖浓度更高。孤立的边界 Q 波与更高的体重指数（与无 Q 波相比的差异：1.0kg/m；95%CI：0.3-1.7；p 值：0.006）、腰围（3.4cm；1.0-5.8；0.005）和内脏脂肪组织（21.9cm；7.4-36.3；0.003）有关，而非孤立边界 Q 波的差异更大。与无 Q 波组相比，非孤立边界 Q 波与更高的 PWV（1.2m/s；0.4-2.0；0.004）和 cIMT（23.4μm；3.0-43.8；0.024）相关，而孤立的边界 Q 波则没有。
与无 Q 波相比，孤立的边界 Q 波参与者的心血管危险因素和身体脂肪指标更高，尤其是腹部肥胖，而非孤立的边界 Q 波组更高。非孤立的边界 Q 波与亚临床动脉粥样硬化和血管僵硬有关。未来的研究应该探讨边界 Q 波在 CVD 预测中的潜在附加价值。
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