The effect of ageing on the frontal QRS-T angle on the 12-lead ECG

The frontal QRS-T angle (QTA) is widely available on routine 12-lead electrocardiograms (ECGs), but its practical significance is little recognised. An abnormally wide QTA is known to be a prognostic predictor of cardiovascular events. It has even been considered as a stronger prognostic predictor than the commonly used ECG parameters including ST-T abnormality and QT prolongation. The aim of this study was to investigate the influence of ageing on the QTA in a low-risk population where there were no obvious ECG abnormalities. Having analysed 437 consecutive patients, we found a positive correlation between age and QTA, but no age difference in heart rate, QRS duration, QT interval and P-wave axis. As hypertension was more prevalent in older patients, we compared patients with hypertension to those without and found no significant difference in QTA. Therefore, ageing alone is a significant contributory factor to the widening of QRS-T angle. Further study to confirm QTA as a prognostic predictor for all-cause mortality, independent of age itself and in the absence of ECG abnormalities, in an older population would be significant.

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