The association of metabolic syndrome and QRS|T angle in US adults (NHANES III)

Ann Noninvasive Electrocardiol. 2020 Jan;25(1):e12678. doi: 10.1111/anec.12678. Epub 2019 Jul 30.

Abstract

Background: Spatial QRS|T angle is a predictor of cardiovascular events. Those with metabolic syndrome have an increased risk of cardiovascular morbidity and mortality. This study investigated the association between metabolic syndrome and spatial QRS|T angle.

Methods: We obtained data from the National Health and Nutritional Examination Survey III on 6,249 adults. We calculated spatial QRS|T angle from the standard 12-lead electrocardiogram and classified it as abnormal, borderline, or normal. We identified metabolic syndrome if at least three of the following were present: abdominal obesity, elevated blood pressure, elevated triglycerides, decreased high-density lipoprotein (HDL), and impaired fasting glucose. We used weighted logistic regression to estimate the effect of metabolic syndrome and its components on QRS|T angle while stratifying by gender and adjusting for age, race, smoking status, heart rate, PR, QT, and QRS interval, and QRS amplitude.

Results: Among men and women, metabolic syndrome, the number of components present, elevated blood pressure, and impaired fasting glucose were positively associated with QRS|T angle. Among women, decreased HDL and abdominal obesity were also positively associated with QRS|T angle.

Conclusions: This study suggests that persons with metabolic syndrome may be at increased risk for ventricular arrhythmias. The use of spatial QRS|T angle to assess this cardiovascular risk is warranted.

Keywords: cardiac arrhythmias; cardiovascular disease; electrocardiography; metabolic syndrome; surveys.

MeSH terms

  • Cross-Sectional Studies
  • Electrocardiography / methods
  • Female
  • Health Surveys / methods*
  • Health Surveys / statistics & numerical data
  • Heart Diseases / complications*
  • Heart Diseases / diagnosis
  • Heart Diseases / physiopathology*
  • Humans
  • Male
  • Metabolic Syndrome / complications*
  • Metabolic Syndrome / physiopathology*
  • Middle Aged
  • United States