Electrocardiographic Tpeak-Tend interval and risk of cardiovascular morbidity and mortality: Results from the Copenhagen ECG study

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• 作者：Troels N. Bachmann ; BSc^* ; ^&dagger ; ; Morten W. Skov ; MD^* ; ^&dagger ; ; Peter V. Rasmussen ; BSc^* ; ^&dagger ; ; Claus Graff ; MSc ; PhD^&Dagger ; ; Adrian Pietersen ; MD^§ ; ; Bent Lind ; MD ; DMSci^§ ; ; Johannes J. Struijk ; MSc ; PhD^&Dagger ; ; Morten S. Olesen ; MSc ; PhD^* ; ^&dagger ; ; Stig Haunsø ; MD ; DMSci^* ; ^&dagger ; ; ^¶ ; ; Lars Kø ; ber ; MD ; DMSci^¶ ; ; Jesper H. Svendsen ; MD ; DMSci^* ; ^&dagger ; ; ^¶ ; ; Anders G. Holst ; MD ; PhD^* ; ^&dagger ; ; Jonas B. Nielsen ; MD ; PhD^* ; ^&dagger ; ; ^‖ ; ^# ; ^{jonas.bille.nielsen@gmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Tpeak&ndash ; Tend interval ; Electrocardiography ; General population ; Death ; Atrial fibrillation ; Heart failure
• 刊名：Heart Rhythm
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：13
• 期：4
• 页码：915-924
• 全文大小：1220 K

文摘

The electrocardiographic Tpeak–Tend interval is considered a novel risk marker of cardiac arrhythmias and cardiovascular death; however, results to date have been conflicting.

Objective

The purpose of this study was to investigate the association between this interval and the risk of all-cause and cardiovascular mortality, atrial fibrillation, and heart failure, allowing for nonlinear relationships.

Methods

From primary care, 138,404 individuals were included and categorized into seven groups based on Tpeak–Tend interval. Cox regression models were used to describe the association between these groups and the risk of the selected outcomes.

Results

Compared with the reference groups (104–115 ms for all-cause mortality and 98–103 ms for all other outcomes), individuals with a Tpeak–Tend interval in lead V₅ <5th percentile (58–77 ms) had hazard ratios of 1.29 (95% confidence interval [CI] 1.21–1.38, P <.001) for all-cause mortality, 1.31 (95% CI 1.15–1.50, P <.001) for cardiovascular death, 1.18 (95% CI 1.06–1.32, P = .003) for atrial fibrillation, and 1.52 (95% CI 1.33–1.74, P <.001) for heart failure. Individuals with a Tpeak–Tend interval ≥95th percentile (116–140 ms) had hazard ratios of 1.15 (95% CI 1.08–1.23, P <.001) for all-cause mortality, 1.30 (95% CI 1.15–1.47, P <.001) for cardiovascular death, 1.09 (95% CI 0.99–1.22, P = .088) for atrial fibrillation, and 1.28 (95% CI 1.12–1.46, P <.001) for heart failure. Similar results were obtained for leads II and V₂.

Conclusion

We observed U-shaped associations between the Tpeak–Tend interval and risk of all-cause and cardiovascular mortality, atrial fibrillation, and heart failure.