.: ORİJİNAL ARAŞTIRMA
Relationship Between Frontal QRS-T Angle and Ascending Aortic Dilatation: A Cross Sectional Study
Frontal QRS-T Açısı ve Asendan Aort Dilatasyonu Arasındaki İlişki: Kesitsel Bir Çalışma
Turkiye Klinikleri J Cardiovasc Sci. 2024;36(1):11-20
doi: 10.5336/cardiosci.2024-102540
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: Few studies have shown that certain myocardial repolarization markers from surface electrocardiogram (ECG) are associated with ascending aortic (AA) dilatation (AAD). We aimed to investigate the association between 12-lead surface ECG markers and AAD. Material and Methods: Consecutive patients without active complaints, who were admitted to the outpatient clinic for routine control, were included in the study. Transthoracic echocardiography (TTE) was performed to measure AA diameter. ECG markers, including QRS duration, TP-e interval, QTc interval, and frontal QRS-T angle were calculated. Patients were divided into two groups based on their AA diameter: those with an AA diameter ≥40 mm [AAD (+)] and those with an AA diameter <40 mm [AAD (-)]. Statistical analysis was performed to compare the two groups using a p value <0.05 as statistically significant. Results: Among the 251 patients, 31 (12.3%) had AAD. Patients with AAD had a significantly higher rate of coronary artery disease (CAD) history. Fragmented QRS, pathological Qwaves, longer P-maximum, P-minimum, P-dispersion, QRS duration, Tp-e duration, R peak time, and increased frontal QRS-T angle were more common in the AAD(+) group (all p<0.05). Correlation analysis revealed a significant correlation between the frontal QRS-T angle and AAD (R=0.379, p<0.001). In multivariate logistic regression analysis, AAD showed an independent association with the frontal QRS-T angle (OR: 3.886, 95% CI: 1.270-11.893, p=0.017) and history of CAD (OR: 10.689, 95% CI: 2.151- 53.121, p=0.004). Conclusion: AAD was independently associated with a CAD history and frontal QRS-T angle.
Keywords: Electrocardiography; frontal QRS-T angle; ascending aorta; ascending aortic dilatation
Objective: Few studies have shown that certain myocardial repolarization markers from surface electrocardiogram (ECG) are associated with ascending aortic (AA) dilatation (AAD). We aimed to investigate the association between 12-lead surface ECG markers and AAD. Material and Methods: Consecutive patients without active complaints, who were admitted to the outpatient clinic for routine control, were included in the study. Transthoracic echocardiography (TTE) was performed to measure AA diameter. ECG markers, including QRS duration, TP-e interval, QTc interval, and frontal QRS-T angle were calculated. Patients were divided into two groups based on their AA diameter: those with an AA diameter ≥40 mm [AAD (+)] and those with an AA diameter <40 mm [AAD (-)]. Statistical analysis was performed to compare the two groups using a p value <0.05 as statistically significant. Results: Among the 251 patients, 31 (12.3%) had AAD. Patients with AAD had a significantly higher rate of coronary artery disease (CAD) history. Fragmented QRS, pathological Qwaves, longer P-maximum, P-minimum, P-dispersion, QRS duration, Tp-e duration, R peak time, and increased frontal QRS-T angle were more common in the AAD(+) group (all p<0.05). Correlation analysis revealed a significant correlation between the frontal QRS-T angle and AAD (R=0.379, p<0.001). In multivariate logistic regression analysis, AAD showed an independent association with the frontal QRS-T angle (OR: 3.886, 95% CI: 1.270-11.893, p=0.017) and history of CAD (OR: 10.689, 95% CI: 2.151- 53.121, p=0.004). Conclusion: AAD was independently associated with a CAD history and frontal QRS-T angle.
Keywords: Electrocardiography; frontal QRS-T angle; ascending aorta; ascending aortic dilatation
ÖZET
Amaç: Az sayıda çalışmada, yüzey elektrokardiyografisinden (EKG) elde edilen bazı miyokardiyal repolarizasyon belirteçlerinin asendan aort (AA) dilatasyonu (AAD) ile ilişkili olduğu gösterilmiştir. Bu çalışmada, 12 derivasyonlu yüzey EKG belirteçleri ile AAD arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntemler: Aktif şikâyeti olmayan, rutin kontrol için polikliniğe başvuran ardışık hastalar çalışmaya dâhil edildi. AA çapını ölçmek için transtorasik ekokardiyografi (TTE) yapıldı. QRS süresi, TP-e aralığı, QTc aralığı ve frontal QRS-T açısı gibi EKG belirteçleri hesaplandı. Hastalar AA çaplarına göre iki gruba ayrıldı: AA çapı ≥ 40 mm olanlar [AAD (+)] ve AA çapı <40 mm olanlar [AAD (-)]. İki grubu karşılaştırmak için istatistiksel analiz yapıldı ve p değeri <0,05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Çalışmaya dâhil edilen 251 hastanın 31'inde (%12,3) AAD vardı. AAD'li hastalarda koroner arter hastalığı (KAH) öyküsünün anlamlı derecede yüksek olduğu görülmüştür. AAD (+) grupta; EKG parametreleri arasından fragmante QRS, patolojik Q dalgaları, daha uzun P-maksimum, Pminimum, P-dispersiyonu, QRS süresi, Tp-e süresi, R pik zamanı ve artmış frontal QRS-T açısı daha yaygındı (tümü p<0,05). Korelasyon analizi frontal QRS-T açısının AAD ile ilişkili olduğunu göstermiştir (R=0,379, p<0,001). Çok değişkenli lojistik regresyon analizinde, AAD ile frontal QRST açısı [göreceli olasılıklar oranı (odds ratio ''OR''): 3,886, %95 güven aralığı (confidence interval ''CI'') 1,270-11,893, p=0,017] ve KAH öyküsü (OR: 10,689, %95 CI 2,151-53,121, p=0,004) arasında bağımsız bir ilişki olduğu bulunmuştur. Sonuç: Çalışmamızda, AAD ile frontal QRS-T açısı ve KAH öyküsü arasında anlamlı bir ilişki bulunmuştur.
Anahtar Kelimeler: Elektrokardiyografi; frontal QRS-T açısı; asendan aort; asendan aort dilatasyonu
Amaç: Az sayıda çalışmada, yüzey elektrokardiyografisinden (EKG) elde edilen bazı miyokardiyal repolarizasyon belirteçlerinin asendan aort (AA) dilatasyonu (AAD) ile ilişkili olduğu gösterilmiştir. Bu çalışmada, 12 derivasyonlu yüzey EKG belirteçleri ile AAD arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntemler: Aktif şikâyeti olmayan, rutin kontrol için polikliniğe başvuran ardışık hastalar çalışmaya dâhil edildi. AA çapını ölçmek için transtorasik ekokardiyografi (TTE) yapıldı. QRS süresi, TP-e aralığı, QTc aralığı ve frontal QRS-T açısı gibi EKG belirteçleri hesaplandı. Hastalar AA çaplarına göre iki gruba ayrıldı: AA çapı ≥ 40 mm olanlar [AAD (+)] ve AA çapı <40 mm olanlar [AAD (-)]. İki grubu karşılaştırmak için istatistiksel analiz yapıldı ve p değeri <0,05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Çalışmaya dâhil edilen 251 hastanın 31'inde (%12,3) AAD vardı. AAD'li hastalarda koroner arter hastalığı (KAH) öyküsünün anlamlı derecede yüksek olduğu görülmüştür. AAD (+) grupta; EKG parametreleri arasından fragmante QRS, patolojik Q dalgaları, daha uzun P-maksimum, Pminimum, P-dispersiyonu, QRS süresi, Tp-e süresi, R pik zamanı ve artmış frontal QRS-T açısı daha yaygındı (tümü p<0,05). Korelasyon analizi frontal QRS-T açısının AAD ile ilişkili olduğunu göstermiştir (R=0,379, p<0,001). Çok değişkenli lojistik regresyon analizinde, AAD ile frontal QRST açısı [göreceli olasılıklar oranı (odds ratio ''OR''): 3,886, %95 güven aralığı (confidence interval ''CI'') 1,270-11,893, p=0,017] ve KAH öyküsü (OR: 10,689, %95 CI 2,151-53,121, p=0,004) arasında bağımsız bir ilişki olduğu bulunmuştur. Sonuç: Çalışmamızda, AAD ile frontal QRS-T açısı ve KAH öyküsü arasında anlamlı bir ilişki bulunmuştur.
Anahtar Kelimeler: Elektrokardiyografi; frontal QRS-T açısı; asendan aort; asendan aort dilatasyonu
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