Aim: We aimed at investigating the association between T-wave axis deviation, metabolic syndrome
(MetS), its components and estimated risk of cardiovascular disease (CVD) at 10 years in a adult
Italian population.
Methods: 11,143 women (54±11 years) and 9,742 men (55±11 years) were analysed from the Molisani
cohort, randomly recruited from the general population. MetS was defined using the ATPIII
criteria. T-wave axis deviation was measured from the standard 12-lead resting electrocardiogram.
CVD risk in ten years was estimated by the CUORE score.
Results: 29% of men and 27% of women with MetS showed borderline or abnormal T-wave as
compared to 24% and 17% without MetS (p<0.0001 for both genders).
Among components of MetS, elevated waist and blood pressure were strongly associated with Twave
axis deviation, whereas glucose, HDL and triglycerides were only marginally. The odds of
having borderline or abnormal T-wave axis deviation in multivariable regression analysis, was 1.38
(95% CI:1.25-1.53) in MetS men and 1.68 (95% CI:1.51-1.87) in MetS women compared to those
without. Further adjustment for MetS components completely abolished the associations. Abnormal
T-wave axis deviation was associated with an increased risk of CVD in 10 years in men (OR=4.4;
95% CI:1.10-17.9).
Conclusion: T-wave axis deviation is strongly associated with components of the MetS, in particular
high waist circumference and blood pressure and with an increased CVD risk, particularly in men.
ECG monitoring to identify T-wave axis deviation in obese, hypertensive or MetS subjects can be an
early indicator of vascular disease and help in reducing cardiac events