학술논문

Electrocardiogram Abnormalities and Coronary Calcification in Postmenopausal Women
Document Type
article
Source
Journal of Tehran University Heart Center, Vol 5, Iss 1, Pp 19-24 (2010)
Subject
Atherosclerosis
Hypertrophy- Left Ventricular
Myocardial Ischemia
Women
Postmenopause
Diseases of the circulatory (Cardiovascular) system
RC666-701
Language
English
ISSN
1735-8620
Abstract
Background: An electrocardiogram (ECG) can provide information on subclinical myocardial damage. The presence,and more importantly, the quantity of coronary artery calcification (CAC), relates well with the overall severity of the atherosclerotic process. A strong relation has been demonstrated between coronary calcium burden and the incidence of myocardial infarction, a relation independent of age. The aim of this study was to assess the relation of left ventricular hypertrophy (LVH) and ECG abnormalities with CAC.Methods: The study population comprised 566 postmenopausal women selected from a population-based cohort study.Information on LVH and repolarization abnormalities (T-axis and QRS-T angle) was obtained using electrocardiography.Modular ECG Analysis System (MEANS) was used to assess ECG abnormalities. The women underwent a multi detectorrow computed tomography (MDCT) scan (Philips Mx 8000 IDT 16) to assess CAC. The Agatston score was used to quantifyCAC; scores greater than zero were considered as the presence of coronary calcium. Logistic regression was used to assessthe relation of ECG abnormality with coronary calcification.Results: LVH was found in 2.7% (n = 15) of the women. The prevalence of T-axis abnormality was 6% (n = 34), whereas 8.5% (n = 48) had a QRS-T angle abnormality. CAC was found in 62% of the women. Compared to women with a normal T-axis, women with borderline or abnormal T-axes were 3.8 fold more likely to have CAC (95% CI: 1.4-10.2). Similarly,compared to women with a normal QRS-T angle, in women with borderline or abnormal QRS-T angle, CAC was 2.0 fold more likely to be present (95% CI: 1.0-4.1).Conclusion: Among women with ECG abnormalities reflecting subclinical ischemia, CAC is commonly found and may in part explain the increased coronary heart disease risk associated with these ECG abnormalities.