T-wave axis deviation and left ventricular hypertrophy interaction in diabetes and hypertension

Deodato Assanelli, Augusto Di Castelnuovo, Livia Rago, Fabio Badilini, Giovanni Vinetti, Francesco Gianfagna, Massimo Salvetti, Francesco Zito, Maria Benedetta Donati, Giovanni De Gaetano, Licia Iacoviello

Research output: Contribution to journalArticlepeer-review


Electrocardiographic signs of left ventricular hypertrophy (ECG-LVH) and T-wave axis (TA) deviation are independent predictors of fatal and non fatal events. We assessed the prevalence of ECG-LVH, TA abnormalities and their combination according to the presence or absence of diabetes and/or hypertension in a large sample of the adult general Italian population. Data from 10,184 women (54 ± 11 years) and 8775 men (54 ± 11 years) were analyzed from the Moli-sani cohort, a database of randomly recruited adults (age > 35) from the general population of Molise, a central region of Italy that includes collection of standard 12-lead resting ECG. Subjects with previous myocardial infarction, angina, cerebrovascular disease or left bundle brunch block or missing values for TA or ECG-LVH have been excluded. TA was measured from the standard 12-lead ECG and it was defined as the rotation of the T wave in the frontal plane as computed by a proprietary algorithm (CalECG/Bravo, AMPS-LLC, NY). ECG-LVH was defined as Sokolow Lyon voltage (SLv) > 35 mm or Cornell voltage duration Product (CP) > = 2440 mm*ms. Among subjects with ECG-LVH, prevalence of hypertension was 59.0% and 49.7%, respectively for men and women, whereas that of diabetes was 10.7% and 5.7%. In hypertensives, TA was normal in 72.3% of subjects, borderline in 24.8% and abnormal in 2.9%. In diabetics, TA was normal in 70.4% of subjects, borderline in 26.5% and abnormal in 3.1%. In both hypertensive and diabetic subjects, the prevalence of ECG-LVH, was significantly greater in subjects with borderline or abnormal TA. Hypertension was an independent predictor of abnormal TA (odd ratio: 1.38, P =.025). These results suggest that hypertension might play a relevant role in the pathogenesis of TA deviation.

Original languageEnglish
Pages (from-to)487-491
Number of pages5
JournalJournal of Electrocardiology
Issue number6
Publication statusPublished - Nov 2013


  • Coronary artery disease
  • Diabetes
  • Hypertension
  • Left ventricular hypertrophy T-wave axes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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