Abstract
Background
Negative T-waves are associated with sudden cardiac death (SCD) in the general population. Whether also low amplitude T-waves link to SCD risk in the general population is unknown.
Purpose
We investigated the prognostic significance of T-wave abnormalities in a general population cohort.
Methods
We evaluated the ECGs of 6584 Finnish general population subjects aged ≥30 years (mean age 51.2±13.9, 45.6% men) and classified them according to the T-wave morphology to 3 classes: 1) negative T-waves (negative T-wave with amplitude ≥0.1mV in ≥2 of the leads I, II, aVL, V4-V6), 2) low amplitude T-waves (negative or positive T-wave with amplitude <0.1mV and amplitude ratio of T-wave and R-wave ≤10% in ≥2 of the leads I, II, aVL, V4-V6), and 3) normal T-waves (not meeting the criteria for negative or low amplitude T-waves). Subjects were followed for 10 years for the occurrence of SCD, cardiac death, or death from any cause.
Results
A total of 239 subjects (3.5%) had negative T-waves, 869 (12.7%) low amplitude T-waves, and 5746 (83.8%) normal T-waves. The Table shows the baseline characteristics. Subjects with T-wave abnormalities were older and had more often cardiovascular morbidities than subjects with normal T-waves. Cardiovascular morbidities were most common in subjects with negative T-waves. After adjusting for multiple clinical factors, negative T-waves (HR 3.91; 95% CI 2.30–6.64) and low amplitude T-waves (HR 1.80; 95% CI 1.13–2.86) were associated with SCD, when compared to normal T-waves. Furthermore, both negative T-waves and low amplitude T-waves associated with cardiac death (HR 2.34; 95% CI 1.75–3.13 and HR 1.49; 95% CI 1.17–1.91, respectively) and death from any cause (HR 1.85; 95% CI 1.50–2.27 and HR 1.45; 95% CI 1.24–1.70, respectively). The Figure displays the survival plots for SCD according to T-wave group.
Conclusion
In addition to negative T-waves, low amplitude T-waves also associate with SCD risk in the general population. Focus should be also placed on these minor T-wave abnormalities in the future.
Kaplan-Meier plot
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): Finnish Medical Foundation, Aarne Koskelo Foundation
P6368Prevalence and prognostic significance of negative U-waves in the 12-lead electrocardiogram in the general population