Relationship Between Frontal QRS-T Angle and Ascending Aortic Dilatation: A Cross Sectional Study

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Objective: Few studies have shown that certain myocardial repolarization markers from surface electrocardiogram (ECG) are associated with ascending aortic (AA) dilatation (AAD). We aimed to investigate the association between 12-lead surface ECG markers and AAD. Material and Methods: Consecutive patients without active complaints, who were admitted to the outpatient clinic for routine control, were included in the study. Transthoracic echocardiography (TTE) was performed to measure AA diameter. ECG markers, including QRS duration, TP-e interval, QTc interval, and frontal QRS-T angle were calculated. Patients were divided into two groups based on their AA diameter: those with an AA diameter ≥40 mm [AAD (+)] and those with an AA diameter <40 mm [AAD (-)]. Statistical analysis was performed to compare the two groups using a p value <0.05 as statistically significant. Results: Among the 251 patients, 31 (12.3%) had AAD. Patients with AAD had a significantly higher rate of coronary artery disease (CAD) history. Fragmented QRS, pathological Qwaves, longer P-maximum, P-minimum, P-dispersion, QRS duration, Tp-e duration, R peak time, and increased frontal QRS-T angle were more common in the AAD(+) group (all p<0.05). Correlation analysis revealed a significant correlation between the frontal QRS-T angle and AAD (R=0.379, p<0.001). In multivariate logistic regression analysis, AAD showed an independent association with the frontal QRS-T angle (OR: 3.886, 95% CI: 1.270-11.893, p=0.017) and history of CAD (OR: 10.689, 95% CI: 2.151- 53.121, p=0.004). Conclusion: AAD was independently associated with a CAD history and frontal QRS-T angle.