Zorlu Çağrı, Açıkel Barış, Ömür Sefa Erdi
Department of Cardiology, Tokat Gaziosmanpasa University Hospital, Tokat, Turkey.
Department of Cardiology, Tokat State Hospital, Toakt, Turkey.
Ann Noninvasive Electrocardiol. 2025 Mar;30(2):e70062. doi: 10.1111/anec.70062.
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.
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.
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.
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.
已知多种心室复极参数可预测各种疾病中的室性心律失常和死亡率。尽管射血分数保留的心力衰竭（HFpEF）患者的死亡率与射血分数降低的心力衰竭患者相似，但关于这一主题的研究更为有限。因此，评估HFpEF患者室性心律失常与死亡率以及心室复极参数之间的关系非常重要，尤其是额面QRS-T角。
评估了811例患者的心电图、超声心动图和实验室数据，并在心电图上计算fQRST角。记录平均48±12个月内室性心动过速、心室颤动或猝死的发生情况。统计学显著性判定为p<0.05。
共评估了811例患者，心脏事件组180例，无心脏事件组631例。心脏事件组的NT-proBNP、左房大小、左房容积指数、Tp-e时间、Tp-e/QTc比值和fQRS-T角在统计学上显著更高。在多变量cox分析中，NT-proBNP水平和fQRS-T角被发现是死亡率的独立预测因素。根据ROC分析，当QRS-T角的截断值为58.63时，其敏感性为81.2，特异性为79.3。Kaplan-Meier分析还发现，当fQRS-T角>58.63时，死亡率高于较窄角度时。
根据我们的研究，可在心电图上轻松且廉价计算的fQRS-T角可预测HFpEF患者的长期室性心律失常。
