Prognostic Values of Clockwise and Counter-Clockwise Rotation for Cardiovascular Mortality in Japanese (24 Year Follow-up of NIPPON DATA80)
Background—Although clockwise (CWR) and counter-clockwise rotation (CCWR) are distinct findings of ECG, their prognostic significance is almost never studied.
Methods and Results—We studied prognostic values of CWR and CCWR on total, cardiovascular disease (CVD) and subtype mortality using the NIPPON DATA80 database with a 24-year follow-up. At the baseline in 1980, data were collected on study participants, ages 30 years and over, from randomly selected areas in Japan. We followed 9,067 participants (44% men, mean age 51). During the 24 year follow-up, there were 2,581 total, 887 CVD, 179 CHD, 173 HF, and 411 stroke mortality. The multivariate-adjusted hazard ratio (HR) using the Cox model including biochemical and other ECG variables revealed that CWR was significantly positively associated with heart failure (HF) in men and women combined (HR=1.79, 95% confidence intervals [CI]: 1.13-2.83, P=0.013), CVD in men and combined (HR=1.49 [1.12-1.98], P=0.007 in men; HR=1.28 [1.02-1.59], P=0.030 in combined), and total mortality in men and combined (HR=1.19 [1.00-1.49], P=0.0496 in men; HR=1.15 [1.00-1.32], P=0.045 in combined). CCWR was significantly inversely associated stroke in combined (HR=0.77 [0.62-0.96], P=0.017), CVD in men and combined (HR=0.74 [0.59-0.94], P=0.011 in men; HR=0.81 [0.70-0.94], P=0.006 in combined), and total mortality in women (HR=0.87 [0.77-0.98], P=0.023).
Conclusions—We found a significant positive association of CWR, and a significant inverse association of CCWR with CVD mortality in men, and in men and women combined, independent of confounding factors including other ECG changes.
- Received September 23, 2011.
- Accepted January 31, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited