{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:14:00Z","timestamp":1790802840721,"version":"4.1.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"25","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2008,6,24]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background\u2014<\/jats:italic>\n            <\/jats:bold>\n            The planar QRS-T angle can be easily obtained from standard 12-lead ECGs, but its predictive ability is not established. We sought to determine the predictive ability of the planar QRS-T angle in patients with nonischemic cardiomyopathy and to assess QRS-T angle behavior over time.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods and Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            Baseline QRS-T angles from 455 patients in the Defibrillators in Nonischemic Cardiomyopathy Treatment Evaluation (DEFINITE) trial were measured. All patients had nonischemic cardiomyopathy, New York Heart Association class I to III heart failure, and nonsustained ventricular tachycardia or frequent ventricular ectopy. The primary end point (a composite of total mortality, appropriate implantable cardioverter-defibrillator shock, or resuscitated cardiac arrest) occurred in 25 of 172 patients (14.5%) with a QRS-T angle \u226490\u00b0 and in 72 of 283 patients (25.4%) with a QRS-T angle &gt;90\u00b0 (hazard ratio, 1.93; 95% confidence interval, 1.23 to 3.05;\n            <jats:italic>P<\/jats:italic>\n            =0.002). A QRS-T angle &gt;90\u00b0 remained a significant predictor of the primary end point (\n            <jats:italic>P<\/jats:italic>\n            =0.039) after adjustment for treatment group, age, gender, QRS duration, left bundle-branch block, left ventricular ejection fraction, New York Heart Association class III, atrial fibrillation, and diabetes mellitus. The secondary end point (total mortality) occurred in 17 of the 172 patients (9.9%) with a QRS-T angle \u226490\u00b0 and in 49 of the 283 patients (17.3%) with a QRS-T angle &gt;90\u00b0 (hazard ratio, 1.79; 95% confidence interval, 1.03 to 3.10;\n            <jats:italic>P<\/jats:italic>\n            =0.016). A sample of 152 patients with multiple follow-up ECGs was analyzed to assess temporal QRS-T angle behavior. Changes in the QRS-T angle correlated with changes in left ventricular ejection fraction and QRS duration over time (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.001).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            A planar QRS-T angle &gt;90\u00b0 is a significant predictor of a composite end point of death, appropriate implantable cardioverter-defibrillator shock, or resuscitated cardiac arrest in nonpaced, mild to moderately symptomatic patients with nonischemic cardiomyopathy with frequent or complex ventricular ectopy. QRS-T angles changed predictably with left ventricular ejection fraction and QRS duration.\n          <\/jats:p>","DOI":"10.1161\/circulationaha.107.733451","type":"journal-article","created":{"date-parts":[[2008,6,23]],"date-time":"2008-06-23T20:58:20Z","timestamp":1214254700000},"page":"3181-3186","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":80,"title":["Prognostic Value and Temporal Behavior of the Planar QRS-T Angle in Patients With Nonischemic Cardiomyopathy"],"prefix":"10.1161","volume":"117","author":[{"given":"Behzad B.","family":"Pavri","sequence":"first","affiliation":[{"name":"From the Department of Medicine, Division of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pa (B.B.P., M.B.H., G.E.B.); Department of Medicine, Division of Cardiology, Northwestern Memorial Hospital, Chicago, Ill (H.S., A.S., A.K.); and Department of Medicine, Division of Cardiology, St Francis Hospital, Roslyn, NY (J.H.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew B.","family":"Hillis","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Division of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pa (B.B.P., M.B.H., G.E.B.); Department of Medicine, Division of Cardiology, Northwestern Memorial Hospital, Chicago, Ill (H.S., A.S., A.K.); and Department of Medicine, Division of Cardiology, St Francis Hospital, Roslyn, NY (J.H.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haris","family":"Subac\u030cius","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Division of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pa (B.B.P., M.B.H., G.E.B.); Department of Medicine, Division of Cardiology, Northwestern Memorial Hospital, Chicago, Ill (H.S., A.S., A.K.); and Department of Medicine, Division of Cardiology, St Francis Hospital, Roslyn, NY (J.H.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genevieve E.","family":"Brumberg","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Division of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pa (B.B.P., M.B.H., G.E.B.); Department of Medicine, Division of Cardiology, Northwestern Memorial Hospital, Chicago, Ill (H.S., A.S., A.K.); and Department of Medicine, Division of Cardiology, St Francis Hospital, Roslyn, NY (J.H.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andi","family":"Schaechter","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Division of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pa (B.B.P., M.B.H., G.E.B.); Department of Medicine, Division of Cardiology, Northwestern Memorial Hospital, Chicago, Ill (H.S., A.S., A.K.); and Department of Medicine, Division of Cardiology, St Francis Hospital, Roslyn, NY (J.H.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph H.","family":"Levine","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Division of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pa (B.B.P., M.B.H., G.E.B.); Department of Medicine, Division of Cardiology, Northwestern Memorial Hospital, Chicago, Ill (H.S., A.S., A.K.); and Department of Medicine, Division of Cardiology, St Francis Hospital, Roslyn, NY (J.H.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Kadish","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Division of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pa (B.B.P., M.B.H., G.E.B.); Department of Medicine, Division of Cardiology, Northwestern Memorial Hospital, Chicago, Ill (H.S., A.S., A.K.); and Department of Medicine, Division of Cardiology, St Francis Hospital, Roslyn, NY (J.H.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013474"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa033088"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043399"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1067\/mhj.2002.122516"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000139311.32278.32"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.84.4.1914093"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0195-668X(03)00203-3"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2004.10.040"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1159\/000076697"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.104.496091"},{"key":"e_1_3_2_11_2","first-page":"201","volume":"37","year":"2004","unstructured":"Malik M, Hnatkova K, Batchvarov VN. Post infarction risk stratification using the 3-D angle between QRS complex and T-wave vectors. J Electrocardiol. 2004; 37S: 201\u2013208.","journal-title":"J Electrocardiol"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.09.082"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.561571"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-89-2-204"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-89-1-55"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(82)90169-2"},{"key":"e_1_3_2_17_2","first-page":"759","volume":"1","year":"1969","unstructured":"Chatterjee K, Harris AM, Davies JG, Leatham A. T wave changes after artificial pacing. Lancet. 1969; 1: 759\u2013760.","journal-title":"Lancet"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.31.6.770"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.63.5.829"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/64.1.156"},{"key":"e_1_3_2_21_2","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/j.2517-6161.1972.tb00899.x","volume":"34","year":"1972","unstructured":"Cox DR. Regression models and life tables (with discussion). J Roy Stat Soc B. 1972; 34: 187\u2013220.","journal-title":"J Roy Stat Soc B"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(87)90280-8"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.30.6.853"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1965.03870060008002"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-0736(70)80009-7"},{"key":"e_1_3_2_26_2","unstructured":"Wagner GS. Marriott\u2019s Practical Electrocardiography. 10th ed. Baltimore Md: Lippincott Williams & Wilkins; 2001: 60."},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1009816228345"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(84)90090-0"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jhh.1001129"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2001.00157.x"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.36.6.823"},{"key":"e_1_3_2_32_2","first-page":"2426.","volume":"114","year":"2006","unstructured":"Costantini O, Rosenbaum DS, Hohnloser SH, Kirk M, Lerman B, Baker II J, Sethuraman B, Dettmer M, for the ABCD Investigators. The Alternans Before Cardioverter Defibrillator (ABCD) trial: a noninvasive strategy for primary prevention of sudden cardiac death using T-wave alternans. Circulation. 2006; 114: 2426.","journal-title":"Circulation"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.107.698019"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.107.733451","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T05:34:27Z","timestamp":1715578467000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.107.733451"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,6,24]]},"references-count":33,"journal-issue":{"issue":"25","published-print":{"date-parts":[[2008,6,24]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.107.733451"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.107.733451","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,6,24]]},"assertion":[{"value":"2008-06-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}