T- wave axis deviation is associated with biomarkers of low-grade inflammation

Marialaura Bonaccio; Augusto Di Castelnuovo; Livia Rago; Amalia De Curtis; Deodato Assanelli; Fabio Badilini; Martino Vaglio; Simona Costanzo; Mariarosaria Persichillo; Chiara Cerletti; Maria Benedetta Donati; Giovanni de Gaetano; Licia Iacoviello; the MOLI-SANI study Investigators; on behalf of

doi:10.1160/TH15-02-0177

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2015; 114(06): 1199-1206
DOI: 10.1160/TH15-02-0177

Blood Cells, Inflammation and Infection

Schattauer GmbH

T- wave axis deviation is associated with biomarkers of low-grade inflammation

Findings from the MOLI-SANI study

Marialaura Bonaccio

¹Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo-NEUROMED, Pozzilli (IS), Italy

,

Augusto Di Castelnuovo

¹Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo-NEUROMED, Pozzilli (IS), Italy

,

Livia Rago

²EPICOMED Research, Srl. Campobasso, Italy

,

Amalia De Curtis

¹Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo-NEUROMED, Pozzilli (IS), Italy

,

Deodato Assanelli

³Department of Sports–Internal Medicine, University of Brescia, Brescia, Italy

,

Fabio Badilini

⁴AMPS LLC, New York, New York, USA

,

Martino Vaglio

⁴AMPS LLC, New York, New York, USA

,

Simona Costanzo

¹Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo-NEUROMED, Pozzilli (IS), Italy

,

Mariarosaria Persichillo

¹Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo-NEUROMED, Pozzilli (IS), Italy

,

Chiara Cerletti

¹Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo-NEUROMED, Pozzilli (IS), Italy

,

Maria Benedetta Donati

¹Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo-NEUROMED, Pozzilli (IS), Italy

,

Giovanni de Gaetano

¹Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo-NEUROMED, Pozzilli (IS), Italy

,

Licia Iacoviello

¹Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo-NEUROMED, Pozzilli (IS), Italy

,

the MOLI-SANI study Investigators

› Author Affiliations

Abstract

Summary

T-wave axis deviation (TDev) may help identifying subjects at risk for major cardiac events and mortality, but the pathogenesis of TDev is not well established; in particular, the possible association between TDev and inflammation is unexplored and unknown. We aimed at investigating the association between low-grade inflammation and TDev abnormalities by conducting a cross-sectional analysis on 17,507 subjects apparently free from coronary heart and haematological diseases enrolled in the MOLI-SANI study. TDev was measured from a standard 12-lead resting electrocardiogram. High sensitivity (Hs) C-reactive protein (CRP), leukocyte (WBC) and platelet counts, neutrophil or granulocyte to lymphocyte ratios were used as markers of inflammation. In multivariable model subjects reporting high CRP levels had higher odds of having borderline and abnormal TDev (OR=1.70; 95 %CI: 1.53–1.90 and OR=1.72; 95 %CI: 1.23–2.41, respectively); the association was still significant, although reduced, after controlling for body mass index (OR=1.17; 95 %CI: 1.05–1.32, for borderline and OR=1.46; 95 %CI: 1.03–2.08, for abnormal). Similarly, higher neutrophil or granulocyte to lymphocyte ratios were associated with increased odds of having abnormal TDev. Neither platelet nor leukocyte counts were associated with abnormal TDev. The relationship between CRP with TDev abnormalities was significantly stronger in men, in non- obese or normotensive individuals, and in those without metabolic syndrome. In conclusion, C-reactive protein and some cellular biomarkers of inflammation such as granulocyte or neutrophil to lymphocyte ratios were independently associated with abnormal TDev, especially in subjects at low CVD risk. These results suggest that a low-grade inflammation likely contributes to the pathogenesis of T- wave axis deviation.

Keywords

T-wave axis deviation - low-grade inflammation - hypertension - obesity - metabolic syndrome

Full Text

References

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