Analysis of 12-lead T-wave morphology for risk stratification after myocardial infarction. Zabel, M., Acar, B., Klingenheben, T., Franz, M., Hohnloser, S., & Malik, M. j-C, 102:1252--1207, September, 2000.
  author =       "M. Zabel and B. Acar and T. Klingenheben and M.R.
                 Franz and S.H. Hohnloser and M. Malik",
  title =        "Analysis of 12-lead {T}-wave morphology for risk
                 stratification after myocardial infarction",
  journal =      j-C,
  year =         "2000",
  month =        sep,
  volume =       "102",
  pages =        "1252--1207",
  robnote =      "BACKGROUND: The aim of the present study was to assess
                 the prognostic value of novel T-wave morphology
                 descriptors derived from resting 12-lead ECGs. METHODS
                 AND RESULTS: In 280 consecutive post-MI patients, a
                 12-lead ECG was recorded before discharge, optically
                 scanned, and digitized. For the present study, 5 T-wave
                 morphology descriptors were automatically calculated
                 after singular value decomposition of the ECG signal.
                 The total cosine R-to-T (TCRT [describes the global
                 angle between repolarization and depolarization
                 wavefront]) and the T-wave loop dispersion were
                 univariately associated (P:=0.0002 and P:<0.002,
                 respectively, U: test) with 27 prospectively defined
                 clinical events in 261 patients (mean follow-up 32+/-10
                 months). Kaplan-Meier event probability curves for
                 strata above and below the median confirmed the strong
                 risk discrimination by TCRT and T-wave loop dispersion
                 (P:<0.003 and P:<0.001, respectively, log-rank test).
                 On Cox regression analysis, with the entering of age,
                 left ventricular ejection fraction, heart rate, QRS
                 width, reperfusion therapy, beta-adrenergic-blocker
                 treatment, and standard deviation of R-R intervals on
                 24-hour Holter monitoring, TCRT (P:<0.03) yielded
                 independent predictive value, whereas T-wave loop
                 dispersion was of borderline independence (P:=0.064).
                 Heart rate (P:<0.02), left ventricular ejection
                 fraction (P:<0.02), and reperfusion therapy (P:<0.02)
                 also remained in the final model. CONCLUSIONS:
                 Computerized T-wave morphology analysis of the 12-lead
                 resting ECG permits independent assessment of post-MI
                 risk and an improved risk stratification when combined
                 with other risk markers.",
  bibdate =      "Tue May 1 16:27:20 2001",

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