JCCVS
Journal of Cardiology & Cardiovascular Surgery

Journal of Cardiology & Cardiovascular Surgery scientific, open-access, double-blind peer-reviewed journal covering a wide spectrum of topics in cardiology and cardiovascular surgery.

eISSN: 2980-1397
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Original Article
Frontal QRS-T angle in COVID-19 patients with reduced left ventricular ejection fraction
Abstract
Aim: Diastolic dysfunction (DD), which often accompanies essential hypertension (HT), can progress to heart failure with preserved ejection fraction. Recent studies have shown an association between chronic inflammation and HT. In this study, we aimed to investigate the neutrophil lymphocyte ratio (NLR) in hypertensive patients with and without DD and the relationship between NLR and DD development. Methods: The study included 50 patients with DD and 50 patients without DD. Left ventricular systolic and diastolic functions were evaluated by echocardiography in all patients. A complete blood count, C-reactive protein (CRP), and NLR were analyzed in blood samples obtained from the patients. Results: There was no significant difference in demographic characteristics and biochemical values between the two groups. White blood cell count and NLR were significantly higher in the group with DD (p<0.001). There was a strong correlation between the presence of DD and NLR in hypertensive patients (r=0.814, p<0.001). Although CRP was between reference values in both groups, it was significantly higher in the group with DD compared to the group without DD (4.40±1.60 vs. 3.70±0.90, p=0.020). Conclusion: NLR can be used to detect DD in patients with hypertension and is an easily accessible and inexpensive inflammatory marker.

Keywords : Hypertension, diastolic dysfunction, neutrophil/lymphocyte ratio

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1. WHO Coronavirus disease dashboard. World Health Organization.https://covid19.who.int/. Accessed November 11, 2022.
2. Alqahtani JS, Oyelade T, Aldhahir AM, et al. Prevalence, severityand mortality associated with COPD and smoking in patients withCOVID-19: a rapid systematic review and meta-analysis. PLoS One2020;15(5):e0233147.
3. Yormaz B, Ergun D, Tulek B, et al. The evaluation of prog- nosticvalue of acute phase reactants in the COVID-19. Bratisl Med J2020;121(9):628-633.
4. Gunduz R, Yildiz BS, Ozgur S, et al. Frontal QRS/T angle can predictmortality in COVID-19 patients. Am J Emerg Med. 2022;58:66-72.doi: 10.1016/j.ajem.2022.05.034. Epub 2022 May 25. PMID: 35636045;PMCID: PMC9131483.
5. Inanc IH, Bursa N, Gultepe A, Bayramoğlu M, Sabanoglu C, Inanc FA.Association among CO- RADS score, co-morbid diseases, and short-term prognosis in COVID-19 infection. Eur Rev Med Pharmacol Sci2022;26(2):653-663.
6. Hariyanto TI, Japar KV, Kwenandar F, et al. Inflammatory andhematologic markers as predic- tors of severe outcomes in COVID-19infection: a systematic review and meta-analysis. Am J Emerg Med.2021;41:110-119.
7. Wungu CDK, Khaerunnisa S, Putri EAC, et al. Meta-analysis of cardiacmarkers for predictive factors on severity and mortality of COVID-19.Int J Infect Dis. 2021;105:551-559.
8. Gunduz R, Yildiz BS, Ozgur S, et al. Frontal QRS/T angle can predictmortality in COVID-19 patients. Am J Emerg Med. 2022;58:66-72.
9. Ocak M, Tascanov MB, Yurt NŞ, Yurt YC. A new predictor forindicating clinical severity and prognosis in COVID-19 patients:Frontal QRS-T angle. Am J Emerg Med. 2021;50:631-635.
10. McCullough S.A., Goyal P., Krishnan U., et al. Electrocardiographicfindings in Coronavirus Disease-19: insights on mortality andunderlying myocardial processes. J Card Fail. 2020;26(7):626-632.
11. Tastan E, İnci &Uuml;, İnci Jr &Uuml;. The relationship between in-hospitalmortality and frontal QRS-T angle in patients with COVID-19. Cureus.2022;14(8):e28506
12. Wang Y, Chen L, Wang J, He X, Huang F, Chen J, et al. Electrocardiogramanalysis of patients with different types of COVID-19. Annals NoninvasElectrocard. 2020;25(6):e12806.
13. McCullough SA, Goyal P, Krishnan U, Choi JJ, Safford MM, OkinPM. Electrocardiographic findings in coronavirus disease-19: insightson mortality and underlying myocardial processes. J Cardiac Fail.2020;26(7):626-632.
14. Macfarlane PW. The frontal plane QRS-T angle. Oxford UniversityPress. 2012;14(6):773-775.
15. Gungor M, Celik M, Yalcinkaya E, et al. The value of frontalplanar QRS-T angle in patients without angiographically apparentatherosclerosis. Med Princip Pract. 2017;26(2):125-131.
16. Castro Hevia J, Antzelevitch C, Torn&eacute;s B&aacute;rzaga F, et al. Tpeak-Tendand Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome. J AmColl Card. 2006;47(9):1828-1834.
17. Oehler A, Feldman T, Henrikson CA, Tereshchenko LG. QRS-T angle: areview. Ann Noninvas Electrocard. 2014;19(6):534-542.
18. Macfarlane PW. The frontal plane QRS-T angle. Europace 2012;14(6):773-775.
19. Oehler A, Feldman T, Henrikson CA, et al. QRS-T angle: a review. AnnNoninvas Electrocard. 2014;19:534-542.
20. Aro AL, Huikuri HV, Tikkanen JT, et al. QRS-T angle as a predictorof sudden cardiac death in a middle-aged general population. Europace2012;14(6):872-876.
21. Borleffs CJW, Scherptong RW, Man S-C, van Welsenes GH, Bax JJ,van Erven L, et al. Predicting ventricular arrhythmias in patients withischemic heart disease: clinical application of the ECG-derived QRS-Tangle. Circulation: Arrhythmia Electrophysiol. 2009;2(5):548-554.
22. Kors JA, Kardys I, van der Meer IM, van Herpen G. Spatial QRS-Tangle as a risk indicator of cardiac death in an elderly population. JElectrocard. 2003;36 Suppl:113-114.
23. Tersalvi G, Vicenzi M, Calabretta D, Biasco L, Pedrazzini G et al.Elevated troponin in patients with coronavirus disease 2019: possiblemechanisms. J Cardiac Fail. 2020;26(6):470-475.
24. Suzuki T, Ito M, Kodama M, Mitsuma W, Izumi D et al. Transient leftventricular dysfunction associated with severe Legionella infection. JCardiol Cases. 2011;3(2):e78-e81.
25. Del Rio R, Marcus NJ, Inestrosa NC. Potential Role of AutonomicDysfunction in Covid-19 Morbidity and Mortality. Front Physiol.2020;11:561749.
26. Inanc IH, Sabanoglu C. Autonomic dysfunction and metabolicdisorders as the possible sequelae of COVID-19 infection. Eur RevMed Pharmacol Sci. 2022 Aug;26(15):5587-5595. doi: 10.26355/eurrev_202208_29431. PMID: 35993657.
27. Whang W, Shimbo D, Levitan EB, et al. Relations between QRS| Tangle, cardiac risk factors, and mortality in the third National Healthand Nutrition Examination Survey (NHANES III). Am J Cardiol.2012;109(7):981-987.
28. Haseeb S, Gul E, &Ccedil;inier G, Bazoukis G, et al. On Behalf of TheInternational Society of Electrocardiology Young Community (ISE-YC). Value of electrocardiography in coronavirus disease 2019(COVID-19). J Electrocardiol. 2020;62:39-45.
29. Long B, Brady WJ, Bridwell RE, et al. Electrocardiographicmanifestations of COVID-19. Am J Emerg Med. 2021;41:96-103.
30. Shi S, Qin M, Shen B, et al. Association of cardiac injury with mortalityin hospitalized patients with COVID-19 in Wuhan, China. JAMACardiol. 2020;5(7):802-810.
31. &Ouml;zt&uuml;rk F, Karaduman M, &Ccedil;oldur R, İncecik Ş, G&uuml;neş Y, Tuncer M.Interpretation of arrhythmogenic effects of COVID-19 disease throughECG. Aging Male. 2020;23(5):1362-1365.
32. Monosilio S, Prosperi S, Squeo MR, Spataro S, Spataro A, MaestriniV. Short and long-term cardiovascular sequelae after SARS-CoV-2 infection: a narrative review focusing on athletes. Viruses.2023;15(2):493.
Article available in :
Volume 1, Issue 3, 2023
Page : 40-44
https://doi.org/10.51271/JCCVS-0012
Article Information
Received : 16 Eyl 2023
Accepted : 29 Eyl 2023
Published : 30 Eyl 2023
Corresponding Author :

Haşim Tüner: Department of Cardiology Memorial Bahçelievler Hospital Istanbul.

[email protected]
Citation : Tüner H, Durmaz Y, Alıç E et al. Frontal QRS-T Angle in COVID-19 Patients with reduced left ventricular ejection fraction. J Cardiol Cardiovasc Surg. 2023;1(3):40-44.

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