Clinical implication of T-wave morphology analysis as a new repolarization descriptor

Abstract

Background: T-wave morphology analysis (TMA) quantifies irregularities of ventricular repolarization based on singular value decomposition of the 12-lead electrocardiogram (ECG). Furthermore, TMA is useful for risk stratification of patients with myocardial infarction (MI), although gender differences in TMA and the relationship between TMA and heart diseases are unknown. The aim of this study was to evaluate the significance of TMA in healthy individuals and patients with heart diseases. Methods and Results: Patients with heart disease and either with or without an implanted cardioverter defibrillator (ICD, n=33, 57±16 years; non-ICD, n=50, 67+10 years) were studied. Normal control ECGs (n=114) were selected from Marquette's database (NC, 33±13 years) and the TMA descriptors, including T-wave morphology dispersion (TMD) and percentage of the loop area (PL), were calculated. TMD was significantly lower in group NC males than in the group NC females (11±5.9 vs 22±16, p<0.0001). PL was significantly higher in group NC than in the ICD and non-ICD groups (0.63±0.12 vs 0.53±0.15, p<0.0001). TMD of group NC was significantly lower than that of the ICD and non-ICD groups (14±11 vs 47±27, p<0.0001). Conclusion: There are gender differences in TMD. Abnormal values for TMA could reflect abnormalities of ventricular repolarization.