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. 2009 Aug;6(8):1202-8, 1208.e1.
doi: 10.1016/j.hrthm.2009.05.006. Epub 2009 May 8.

Predictive value of electrocardiographic QT interval and T-wave morphology parameters for all-cause and cardiovascular mortality in a general population sample

Kimmo Porthan  1 , Matti Viitasalo, Antti Jula, Antti Reunanen, Janne Rapola, Heikki Väänänen, Markku S Nieminen, Lauri Toivonen, Veikko Salomaa, Lasse Oikarinen
Affiliations

Predictive value of electrocardiographic QT interval and T-wave morphology parameters for all-cause and cardiovascular mortality in a general population sample

Kimmo Porthan et al. Heart Rhythm. 2009 Aug.

Abstract

Background: The predictive value of ECG QT interval for mortality in the general population has been weak. Only a few population studies on the predictive value of ECG T-wave morphology parameters for mortality have been reported.

Objective: The purpose of this study was to examine the predictive value of ECG QT interval and T-wave morphology parameters for all-cause and cardiovascular mortality in the general population.

Methods: The prognostic values of ECG QT interval and four T-wave morphology parameters (principal component analysis ratio, T-wave morphology dispersion, total cosine R-to-T, T-wave residuum) were assessed in 5,917 adults (45% men; age 52 +/- 14 years) participating in the Finnish population-based Health 2000 Study.

Results: After a mean follow-up of 5.9 +/- 0.8 years, 335 deaths had occurred, including 131 cardiovascular deaths. QT interval and, with a few exceptions, all T-wave morphology parameters were significant univariate mortality predictors. In men, in Cox multivariate analyses, principal component analysis ratio and T-wave morphology dispersion remained as independent predictors of all-cause and cardiovascular mortality, with the above-median T-wave morphology dispersion group showing the highest risk of cardiovascular death (hazard ratio [HR] 4.4, 95% confidence interval [CI] 2.1-9.4). In women, independent mortality predictors were total cosine R-to-T (cardiovascular mortality) and T-wave residuum (all-cause and cardiovascular mortality), with the above-median T-wave residuum group showing the highest risk of cardiovascular death (HR 2.2, 95% CI 1.1-4.2).

Conclusion: In the general population, T-wave morphology parameters, but not heart rate-corrected QT interval, provide independent prognostic information on mortality. The prognostic value of T-wave morphology parameters is specifically related to cardiovascular mortality and seems to be gender specific.

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Comment in

  • The T wave: "only the shadow knows".
    Gettes LS. Gettes LS. Heart Rhythm. 2009 Aug;6(8):1209-10. doi: 10.1016/j.hrthm.2009.06.003. Epub 2009 Jun 6. Heart Rhythm. 2009. PMID: 19632635 No abstract available.

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