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Heart Rhythm. 2016 Apr;13(4):915-24. doi: 10.1016/j.hrthm.2015.12.027. Epub 2015 Dec 18.

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

Author information

1
Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark; Laboratory for Molecular Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
2
Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
3
Copenhagen General Practitioners' Laboratory, Copenhagen, Denmark.
4
Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark; Laboratory for Molecular Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
5
Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
6
Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark; Laboratory for Molecular Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan; Department of Human Genetics, University of Michigan, Ann Arbor, Michigan. Electronic address: jonas.bille.nielsen@gmail.com.

Abstract

BACKGROUND:

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.

KEYWORDS:

Atrial fibrillation; Death; Electrocardiography; General population; Heart failure; Tpeak–Tend interval

PMID:
26707793
DOI:
10.1016/j.hrthm.2015.12.027
[Indexed for MEDLINE]
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