Iranian Heart Journal

Iranian Heart Journal

Association Between Spatial QRS-T Angle and Anthropometric/Lipid-Derived Indices

Document Type : Original Article

Authors
Marwan S.M. Al-Nimer 1
Ismail Ibrahim Hussein 2
Ahmed Khalid Abdullah 3
Suad Muslih Al-Deen Abdul Majeed 4
1 Department of Clinical Pharmacology and Therapeutics, College of Medicine, University of Diyala, 32001 Baqubah, Iraq.
2 Department of Physiology, College of Medicine, Mustansiriyah University. 10011 Baghdad, Iraq.
3 Department of Physiology, College of Medicine, University of Diyala, 32001 Baqubah, Iraq.
4 Department of Physiology-Medical Physics, University of Diyala, 32001 Baqubah, Iraq.
Abstract
Background: Estimating the spatial QRS-T angle (SA) serves as a valuable predictor of abnormal ventricular repolarization sequences, with a wider SA linked to an increased risk of cardiovascular events. SA can be derived from 12-lead ECGs. This study aimed to determine the factors influencing the magnitude of SA, including estimation methods, gender, anthropometric measures, and lipid profile–derived ratios and indices in healthy individuals.
 
Methods: This cross-sectional study involved 138 healthy participants. The primary outcome was the estimation of SA from 12-lead ECGs using 3 different modules: module 1 (aVF, V2, V5, and V6), module 2 (aVF, V2, and V6), and module 3 (I, aVF, and V5). Secondary outcomes involved ratios and indices derived from weight, height, waist circumference, serum triglycerides, and high-density lipoprotein levels.
 
Results: Significant variability in estimating the SA degree and detecting abnormal widening of the SA (> 135°) was found to be related to the measurement modules used. Women exhibited significantly lower SA degrees than men. Estimated total body mass and relative fat mass were important confounding factors contributing to the differences between modules in SA estimation. Among the modules, module 1 demonstrated greater accuracy than the others.
 
Conclusions: An accurate estimation of SA depends on the selected ECG leads, as well as adjustments for anthropometric measurements and gender. (Iranian Heart Journal 2025; 26(3): 59-68)
Keywords
Spatial QRS-T angle
Modules
Gender
Anthropometric measurements
Lipid profile
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Iranian Heart Journal
Volume 26, Issue 3
Summer 2025
Pages 59-68