Intra-subject stability of different expressions of spatial QRS-T angle and their relationship to heart rate (2024)

Andršová, I., Hnatkova, K., Toman, O., Šišáková, M., Smetana, P., Huster, K. M., Barthel, P., Novotný, T., Schmidt, G., & Malik, M. (2022). Intra-subject stability of different expressions of spatial QRS-T angle and their relationship to heart rate. Frontiers in Physiology, 13, Article 939633. https://doi.org/10.3389/fphys.2022.939633

Andršová, Irena ; Hnatkova, Katerina ; Toman, Ondřej et al. / Intra-subject stability of different expressions of spatial QRS-T angle and their relationship to heart rate. In: Frontiers in Physiology. 2022 ; Vol. 13.

@article{2dd900c18ad74b398b0bd3a1c3bd74db,

title = "Intra-subject stability of different expressions of spatial QRS-T angle and their relationship to heart rate",

abstract = "Three-dimensional angle between the QRS complex and T wave vectors is a known powerful cardiovascular risk predictor. Nevertheless, several physiological properties of the angle are unknown or poorly understood. These include, among others, intra-subject profiles and stability of the angle relationship to heart rate, characteristics of angle/heart-rate hysteresis, and the changes of these characteristics with different modes of QRS-T angle calculation. These characteristics were investigated in long-term 12-lead Holter recordings of 523 healthy volunteers (259 females). Three different algorithmic methods for the angle computation were based on maximal vector magnitude of QRS and T wave loops, areas under the QRS complex and T wave curvatures in orthogonal leads, and weighted integration of all QRS and T wave vectors moving around the respective 3-dimensional loops. These methods were applied to orthogonal leads derived either by a uniform conversion matrix or by singular value decomposition (SVD) of the original 12-lead ECG, giving 6 possible ways of expressing the angle. Heart rate hysteresis was assessed using the exponential decay models. All these methods were used to measure the angle in 659,313 representative waveforms of individual 10-s ECG samples and in 7,350,733 individual beats contained in the same 10-s samples. With all measurement methods, the measured angles fitted second-degree polynomial regressions to the underlying heart rate. Independent of the measurement method, the angles were found significantly narrower in females (p < 0.00001) with the differences to males between 10o and 20o, suggesting that in future risk-assessment studies, different angle dichotomies are needed for both sexes. The integrative method combined with SVD leads showed the highest intra-subject reproducibility (p < 0.00001). No reproducible delay between heart rate changes and QRS-T angle changes was found. This was interpreted as a suggestion that the measurement of QRS-T angle might offer direct assessment of cardiac autonomic responsiveness at the ventricular level.",

keywords = "ECG measurements, healthy volunteers, heart rate, heart rate hysteresis, long-term ECG, polynomial regression, sex differences, spatial QRS-T angle",

author = "Irena Andr{\v s}ov{\'a} and Katerina Hnatkova and Ond{\v r}ej Toman and Martina {\v S}i{\v s}{\'a}kov{\'a} and Peter Smetana and Huster, {Katharina M.} and Petra Barthel and Tom{\'a}{\v s} Novotn{\'y} and Georg Schmidt and Marek Malik",

note = "Publisher Copyright: Copyright {\textcopyright} 2022 Andr{\v s}ov{\'a}, Hnatkova, Toman, {\v S}i{\v s}{\'a}kov{\'a}, Smetana, Huster, Barthel, Novotn{\'y}, Schmidt and Malik.",

year = "2022",

month = aug,

day = "30",

doi = "10.3389/fphys.2022.939633",

language = "English",

volume = "13",

journal = "Frontiers in Physiology",

issn = "1664-042X",

publisher = "Frontiers Media S.A.",

}

Andršová, I, Hnatkova, K, Toman, O, Šišáková, M, Smetana, P, Huster, KM, Barthel, P, Novotný, T, Schmidt, G & Malik, M 2022, 'Intra-subject stability of different expressions of spatial QRS-T angle and their relationship to heart rate', Frontiers in Physiology, vol. 13, 939633. https://doi.org/10.3389/fphys.2022.939633

Intra-subject stability of different expressions of spatial QRS-T angle and their relationship to heart rate. / Andršová, Irena; Hnatkova, Katerina; Toman, Ondřej et al.
In: Frontiers in Physiology, Vol. 13, 939633, 30.08.2022.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Intra-subject stability of different expressions of spatial QRS-T angle and their relationship to heart rate

AU - Andršová, Irena

AU - Hnatkova, Katerina

AU - Toman, Ondřej

AU - Šišáková, Martina

AU - Smetana, Peter

AU - Huster, Katharina M.

AU - Barthel, Petra

AU - Novotný, Tomáš

AU - Schmidt, Georg

AU - Malik, Marek

N1 - Publisher Copyright:Copyright © 2022 Andršová, Hnatkova, Toman, Šišáková, Smetana, Huster, Barthel, Novotný, Schmidt and Malik.

PY - 2022/8/30

Y1 - 2022/8/30

N2 - Three-dimensional angle between the QRS complex and T wave vectors is a known powerful cardiovascular risk predictor. Nevertheless, several physiological properties of the angle are unknown or poorly understood. These include, among others, intra-subject profiles and stability of the angle relationship to heart rate, characteristics of angle/heart-rate hysteresis, and the changes of these characteristics with different modes of QRS-T angle calculation. These characteristics were investigated in long-term 12-lead Holter recordings of 523 healthy volunteers (259 females). Three different algorithmic methods for the angle computation were based on maximal vector magnitude of QRS and T wave loops, areas under the QRS complex and T wave curvatures in orthogonal leads, and weighted integration of all QRS and T wave vectors moving around the respective 3-dimensional loops. These methods were applied to orthogonal leads derived either by a uniform conversion matrix or by singular value decomposition (SVD) of the original 12-lead ECG, giving 6 possible ways of expressing the angle. Heart rate hysteresis was assessed using the exponential decay models. All these methods were used to measure the angle in 659,313 representative waveforms of individual 10-s ECG samples and in 7,350,733 individual beats contained in the same 10-s samples. With all measurement methods, the measured angles fitted second-degree polynomial regressions to the underlying heart rate. Independent of the measurement method, the angles were found significantly narrower in females (p < 0.00001) with the differences to males between 10o and 20o, suggesting that in future risk-assessment studies, different angle dichotomies are needed for both sexes. The integrative method combined with SVD leads showed the highest intra-subject reproducibility (p < 0.00001). No reproducible delay between heart rate changes and QRS-T angle changes was found. This was interpreted as a suggestion that the measurement of QRS-T angle might offer direct assessment of cardiac autonomic responsiveness at the ventricular level.

AB - Three-dimensional angle between the QRS complex and T wave vectors is a known powerful cardiovascular risk predictor. Nevertheless, several physiological properties of the angle are unknown or poorly understood. These include, among others, intra-subject profiles and stability of the angle relationship to heart rate, characteristics of angle/heart-rate hysteresis, and the changes of these characteristics with different modes of QRS-T angle calculation. These characteristics were investigated in long-term 12-lead Holter recordings of 523 healthy volunteers (259 females). Three different algorithmic methods for the angle computation were based on maximal vector magnitude of QRS and T wave loops, areas under the QRS complex and T wave curvatures in orthogonal leads, and weighted integration of all QRS and T wave vectors moving around the respective 3-dimensional loops. These methods were applied to orthogonal leads derived either by a uniform conversion matrix or by singular value decomposition (SVD) of the original 12-lead ECG, giving 6 possible ways of expressing the angle. Heart rate hysteresis was assessed using the exponential decay models. All these methods were used to measure the angle in 659,313 representative waveforms of individual 10-s ECG samples and in 7,350,733 individual beats contained in the same 10-s samples. With all measurement methods, the measured angles fitted second-degree polynomial regressions to the underlying heart rate. Independent of the measurement method, the angles were found significantly narrower in females (p < 0.00001) with the differences to males between 10o and 20o, suggesting that in future risk-assessment studies, different angle dichotomies are needed for both sexes. The integrative method combined with SVD leads showed the highest intra-subject reproducibility (p < 0.00001). No reproducible delay between heart rate changes and QRS-T angle changes was found. This was interpreted as a suggestion that the measurement of QRS-T angle might offer direct assessment of cardiac autonomic responsiveness at the ventricular level.

KW - ECG measurements

KW - healthy volunteers

KW - heart rate

KW - heart rate hysteresis

KW - long-term ECG

KW - polynomial regression

KW - sex differences

KW - spatial QRS-T angle

UR - http://www.scopus.com/inward/record.url?scp=85138301822&partnerID=8YFLogxK

U2 - 10.3389/fphys.2022.939633

DO - 10.3389/fphys.2022.939633

M3 - Article

AN - SCOPUS:85138301822

SN - 1664-042X

VL - 13

JO - Frontiers in Physiology

JF - Frontiers in Physiology

M1 - 939633

ER -

Andršová I, Hnatkova K, Toman O, Šišáková M, Smetana P, Huster KM et al. Intra-subject stability of different expressions of spatial QRS-T angle and their relationship to heart rate. Frontiers in Physiology. 2022 Aug 30;13:939633. doi: 10.3389/fphys.2022.939633