The association between environmental cadmium exposure and frontal T wave axis deviation, a valuable and easily detected subclinical marker of ventricular arrhythmias in individuals without heart disease is unexplored and unknown. The objective of the study was to test the hypothesis that cadmium exposure predicts frontal T-wave axis deviation. US adults 40 years of age or older from NHANES III were included in the analysis. The participants' creatinine-corrected urinary cadmium concentrations expressed as micrograms per gram were determined. Frontal T-wave axis deviations were measured from the standard 12-lead electrocardiogram. Multivariable regression analyses adjusting for age, race, smoking, metabolic syndrome, left ventricular mass, QRS duration and heart rate were performed. The odds ratio of borderline and abnormal frontal T wave axis deviations due to cadmium exposure and their corresponding 95% confidence intervals (CIs) were 1.25 (1.10-1.54) and 1.64 (1.27-2.12), respectively. This study documents a positive graded relationship between environmental cadmium exposure and the risk for frontal T-wave axis deviation. Screening individuals with large body burden of cadmium to identify frontal T-wave axis deviation is warranted.

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