FRONTAL QRS-T ANGLE AS A MARKER OF LEFT VENTRICULAR HYPERTROPHY IN PATIENTS WITH ESSENTIAL HYPERTENSION

Objective: Previous studies showed that myocardial repolarization markers are prolonged in hypertensive patients with left ventricular hypertrophy (LVH) compared to patients with non-LVH. Frontal QRS-T angle, angle between the QRS and T wave axes, is novel marker of myocardial repolarization. The aim of our study is to investigate the relationship between frontal QRS-T angle and LVH in hypertensive patients. Material and Method: A total 187 hypertensive patients were included our study. Frontal QRS-T angle was obtained from the automatic reports of the ECG machine. LVH was defined as left ventricular mass index (LVMI) > 115 g/m2 in men and 95 g/m2 in women. Results: Patients with LVH had significantly longer QT dispersion (p=0.028), corrected QT dispersion (p=0.010), Tp-e interval (p = 0.045) and wider frontal QRS-T angle (p<0.001) compared to patients with non-LVH. In correlation analysis, LVMI was positively correlated with QT dispersion (r=0.150, p=0.041), corrected QT dispersion (r=0.167, p=0.022), Tp-e interval (r = 0.160, p = 0.046) and frontal QRS-T angle (r=0.360, p<0.001). By a multivariate analysis, frontal QRS-T (OR: 1.04, 95% CI: 1.02-1.06, P < 0.001) angle was found to be the only independent predictor of LVH. ROC curve analysis showed that the best cut-off value of frontal QRS-T angle for predicting LVH was ≥ 28o. This cut-off value predicted LVH with a sensitivity of 70.5% and a specificity of 54.5%. Conclusion: Frontal QRS-T angle is a simple, inexpensive and easily obtainable parameter from surface electrocardiography. It can be used as a simple marker of LVH in hypertensive subjects