Trends and Thematic Evolution in Frontal QRS-T Angle Research: A Bibliometric Analysis from 2020 to 2025

Aim: The frontal QRS-T angle (fQRST) has gained increasing attention as a simple, widely accessible electrocardiographic marker reflecting ventricular depolarization-repolarization heterogeneity and electrical instability. Beyond cardiac disorders, emerging evidence links fQRST to systemic inflammation, metabolic stress, and a variety of acute clinical conditions. Despite this growing interest, the global evolution, conceptual structure, and research dynamics of fQRST studies have not been systematically characterized.

Methodology: A bibliometric analysis was performed using the Web of Science Core Collection to identify original research articles on fQRST published between 2020 and 2025. After data cleaning and standardization, 138 eligible articles were analyzed. Performance indicators -including publication trends, country and institution productivity, journal distribution, and citation metrics- were evaluated using Bibliometrix (R). Keyword co-occurrence patterns and country-level collaboration structures were visualized through VOSviewer.

Results: Research output on fQRST increased substantially during the study period, peaking in 2023. Türkiye contributed the majority of publications (79.7%), followed by China, Italy, and Japan. The most influential articles primarily focused on coronary syndromes, repolarization abnormalities, COVID-19, arrhythmia risk, and the prognostic implications of ventricular electrical heterogeneity. Seventy-one journals published fQRST-related studies, with the Journal of Electrocardiology serving as the leading outlet. Keyword evolution demonstrated a clear thematic shift from early electrophysiological and measurement-oriented terms toward clinically oriented concepts such as mortality, heart failure, arrhythmia, and systemic inflammation. Collaboration patterns were predominantly national, indicating limited international research integration.

Conclusion: Scientific interest in the frontal QRS-T angle has expanded markedly in recent years, accompanied by thematic diversification and increasing clinical relevance. The concentration of research productivity within specific regions and the limited extent of global collaboration underscore the need for broader, multicenter efforts. Overall, the findings highlight the growing importance of fQRST as an accessible biomarker and support future research incorporating large-scale datasets and advanced analytical methods.