Background

Negative T-waves are associated with sudden cardiac death (SCD) risk in the general population. Whether flat T-waves also predict SCD is not known. The aim of the study was to examine the clinical characteristics and risk of SCD in general population subjects with flat T-waves.

Methods

We examined the electrocardiograms of 6750 Finnish general population adults aged ≥30 years and classified the subjects into 3 groups: 1) negative T-waves with an amplitude ≥0.1 mV in ≥2 of the leads I, II, aVL, V4–V6, 2) negative or positive low amplitude T-waves with an amplitude <0.1 mV and the ratio of T-wave and R-wave <10% in ≥2 of the leads I, II, aVL, V4–V6, and 3) normal positive T-waves (not meeting the aforesaid criteria). The association between T-wave classification and SCD was assessed during a 10-year follow-up.

Results

A total of 215 (3.2%) subjects had negative T-waves, 856 (12.7%) flat T-waves, and 5679 (84.1%) normal T-waves. Flat T-wave subjects were older and had more often cardiovascular morbidities compared to normal T-wave subjects, while negative T-wave subjects were the oldest and had most often cardiovascular morbidities. After adjusting for multiple factors, both flat T-waves (hazard ratio [HR] 1.81; 95% confidence interval [CI] 1.13–2.91) and negative T-waves (HR 3.27; 95% CI 1.85–5.78) associated with SCD.

Conclusions

Cardiovascular risk factors and disease are common among subjects with flat T-waves, but these minor T-wave abnormalities are also independently associated with increased SCD risk.

中文翻译：

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普通人群侧导联中平坦 T 波的预后意义

背景

在一般人群中，负 T 波与心源性猝死 (SCD) 风险相关。平坦的 T 波是否也能预测 SCD 尚不清楚。该研究的目的是检查具有平坦 T 波的普通人群受试者的临床特征和 SCD 风险。

方法

我们检查了 6750 名 30 岁以上的芬兰普通人群的心电图，并将受试者分为 3 组：1) 在 I、II、aVL、V4-V6 导联中的≥2 个导联中出现幅度≥0.1 mV 的负 T 波， 2) I、II、aVL、V4-V6 导联中≥2 个导联的负或正低振幅 T 波，幅度 <0.1 mV，T 波和 R 波之比 <10%，和 3) 正常阳性 T 波（不符合上述标准）。在 10 年的随访期间评估了 T 波分类和 SCD 之间的关联。

结果

共有 215 (3.2%) 名受试者有负 T 波，856 (12.7%) 名 T 波平坦，5679 (84.1%) 名 T 波正常。与正常 T 波受试者相比，平坦 T 波受试者年龄更大，心血管疾病发病率更高，而负 T 波受试者年龄最大，心血管疾病发病率最高。调整多个因素后，平坦的 T 波（风险比 [HR] 1.81；95% 置信区间 [CI] 1.13–2.91）和负 T 波（HR 3.27；95% CI 1.85–5.78）都与 SCD 相关。

结论

心血管危险因素和疾病在 T 波平坦的受试者中很常见，但这些轻微的 T 波异常也与 SCD 风险增加独立相关。