Open Access Research article

The association of spatial T wave axis deviation with incident coronary events. The ARIC cohort

Georgeta D Vaidean1*, Pentti M Rautaharju2, Ronald J Prineas2, Eric A Whitsel3, Lloyd E Chambless4, Aaron R Folsom5, Wayne D Rosamond1, Zhu-Ming Zhang2, Richard S Crow5 and Gerardo Heiss1

Author Affiliations

1 Department of Epidemiology, University of North Carolina at Chapel Hill, USA

2 Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA

3 Department of Epidemiology and Department of Medicine, University of North Carolina at Chapel Hill, USA

4 Department of Biostatistics, University of North Carolina at Chapel Hill, USA

5 Division of Epidemiology, University of Minnesota, Minneapolis, Minnesota, USA

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BMC Cardiovascular Disorders 2005, 5:2  doi:10.1186/1471-2261-5-2

Published: 11 January 2005



Although current evidence suggests that the spatial T wave axis captures important information about ventricular repolarization abnormalities, there are only a few and discordant epidemiologic studies addressing the ability of the spatial T wave axis to predict coronary heart disease (CHD) occurrence.


This prospective study analyzed data from 12,256 middle-aged African American and white men and women, from the Atherosclerosis Risk in Communities Study (ARIC). Following a standardized protocol, resting standard 12-lead, 10-second electrocardiograms were digitized and analyzed with the Marquette GE program. The median follow-up time was 12.1 years; incident coronary heart disease comprised fatal and non-fatal CHD events.


The incidence rate of CHD was 4.26, 4.18, 4.28 and 5.62 per 1000 person-years respectively, across the spatial T wave axis quartiles. Among women for every 10 degrees increase in the spatial T wave axis deviation, there was an estimated increase in the risk of CHD of 1.16 (95% CI 1.04–1.28). After adjustment for age, height, weight, smoking, hypertension, diabetes, QRS axis and minor T wave abnormalities, this hazard rate ratio for women fell to 1.03 (0.92–1.14). The corresponding crude and adjusted hazard ratios for men were 1.05 (95% CI 0.96–1.15) and 0.95 (0.86–1.04) respectively.


In conclusion, this prospective, population-based, bi-ethnic study of men and women free of coronary heart disease at baseline shows that spatial T wave axis deviation is not associated with incident coronary events during long-term follow up. It is doubtful that spatial T wave axis deviation would add benefit in the prediction of CHD events above and beyond the current traditional risk factors.