The Status of Frontal QRS-T Angle in Hypertensive Patients with Different Left Ventricular Geometry

Abstract

Objective: Assessing left ventricular (LV) structure and function gives information on cardiovascular morbidity and mortality, making it important for evaluating hypertensive heart disease. Frontal QRS-T angle (fQRSTa) is a novel approach to quantify the heterogeneity between myocardial depolarization and repolarization. The main purpose here was to define the correlation between different LV geometric patterns and fQRSTa in patients with hypertension (HT). Materials and Methods: 273 patients with hypertension who admitted to the cardiology out-patient clinic were enrolled consecutively. All patients were evaluated by transthoracic echocardiography and classified into three groups based on LV hypertensive geometry as normal geometry (group 0), concentric remodeling (group 1), and concentric or eccentric hypertrophy (group 2). The fQRSTa was defined as the absolute angle difference between frontal plane QRS axis and T wave axis. Results: Compared with group 0, fQRSTa was higher in group 1 (12 [6 – 19] vs. 17 [12 – 24], p=0.023) and group 2 (12 [6 – 19] vs. 39 [28 – 54], p<0.001). Also, fQRSTa was higher in group 2 than group 1 (p<0.001). Correlation analysis revealed a significant correlation between fQRSTa and LV geometry (r=0.525, p<0.001). Multiple linear regression analysis revealed that fQRSTa was independently correlated with LV geometry (β=0.257, p<0.001). Conclusion: Patients with LVH were found to have wider fQRSTa and longer QT duration compared to those with normal ventricles or concentric remodeling.