Electrocardiographic Analysis in Predictive Cardiovascular Assessment
Summary
Electrocardiographic analysis harnesses surface electrical recordings to characterise cardiac electrophysiology and stratify risk of adverse outcomes. Traditional metrics such as heart rate, QRS duration and corrected QT interval have long underpinned assessment of arrhythmic and ischaemic substrates. More sophisticated measures—most notably the QRS-T angle—quantify discordance between depolarisation and repolarisation vectors and reflect global electrical heterogeneity. Vectorcardiographic indices, including the spatial ventricular gradient, further delineate three-dimensional electrical forces. Contemporary research integrates dynamic, time-dependent evaluation of biomarkers to distinguish transient triggers from persistent substrates of sudden cardiac death and other major events. Machine-learning approaches and signal-averaging methods have improved identification of repolarisation lability and stable representative complexes. Across diverse populations—from general cohorts to specialised subgroups such as haemodialysis patients—electrocardiographic biomarkers are demonstrating sustained prognostic value. The evolving paradigm now emphasises periodic reassessment, composite risk scores and multimodal correlation with imaging indices, thereby enhancing personalised prediction and guiding preventive strategies on a global scale.
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Electrocardiographic Analysis in Predictive Cardiovascular Assessment publication trend
The graph below shows the total number of articles in electrocardiographic analysis in predictive cardiovascular assessment across all publications each year (not limited to Nature Index journals).
Technical terms
Electrocardiographic (ECG) QRS-T angle: the angular difference between ventricular depolarisation (QRS) and repolarisation (T) vectors, indicating electrical heterogeneity.
Spatial Ventricular Gradient (SVG): a vectorcardiographic measure of net difference between depolarisation and repolarisation forces across all three axes, reflecting regional imbalances.
Total Cosine R to T (TCRT): a scalar metric derived from ECG signal decomposition that quantifies the cosine of the angle between R- and T-wave vectors, used to assess repolarisation abnormalities.
Global Longitudinal Strain (GLS): an echocardiographic index of myocardial deformation measuring the percentage of longitudinal fibre shortening during systole, indicative of systolic function.
References
- Spatial/Frontal QRS-T Angle Predicts All-Cause Mortality and Cardiac Mortality: A Meta-Analysis. PLOS ONE (2015).
- Dynamic predictive accuracy of electrocardiographic biomarkers of sudden cardiac death within a survival framework: the Atherosclerosis Risk in Communities (ARIC) study. BMC Cardiovascular Disorders (2019).
- QRS-T Angle Predicts Cardiac Risk and Correlates With Global Longitudinal Strain in Prevalent Hemodialysis Patients. Frontiers in Physiology (2019).
- Automatic identification of a stable QRST complex for non-invasive evaluation of human cardiac electrophysiology. PLOS ONE (2020).
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