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- Potter, Samara L. Poplack, et al.
(author)
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Detection of hypertrophic cardiomyopathy is improved when using advanced rather than strictly conventional 12-lead electrocardiogram
- 2010
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In: Journal of Electrocardiology. - : Elsevier BV. - 1532-8430 .- 0022-0736. ; 43:6, s. 713-718
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Journal article (peer-reviewed)abstract
- Introduction: Twelve-lead electrocardiogram (ECG) is used to screen for hypertrophic cardiomyopathy (HCM), but up to 25% of HCM patients do not have distinctly abnormal ECGs, whereas up to 5% to 15% of healthy athletes do. We hypothesized that an approximately 5-minute resting advanced 12-lead ECG test ("A-ECG score") could detect HCM with greater sensitivity than pooled conventional ECG criteria and distinguish healthy athletes from HCM with greater specificity. Materials and methods: Five-minute 12-lead ECGs were obtained from 56 HCM patients, 56 age/sex-matched healthy controls, and 69 younger endurance-trained athletes. Electrocardiograms were analyzed using recently suggested pooled conventional ECG criteria and also A-ECG scoring techniques that considered results from multiple advanced and conventional ECG parameters. Results: Compared with pooled criteria from the strictly conventional ECG, an A-ECG logistic score incorporating results from just 3 advanced ECG parameters (spatial QRS-T angle, unexplained portion of QT variability, and T-wave principal component analysis ratio) increased the sensitivity of ECG for identifying HCM from 89% (78%-96%) to 98% (89%-100%; P = .025), while increasing specificity from 90% (83%-94%) to 95% (92%-99%; P = .020). Conclusions: Resting 12-lead A-ECG scores that are simultaneously more sensitive than pooled conventional ECG criteria for detecting HCM and more specific for distinguishing healthy athletes and other healthy controls from HCM can be constructed. Pending further prospective validation, such scores may lead to improved ECG-based screening for HCM. Published by Elsevier Inc.
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| 2. |
- Schlegel, Todd T., et al.
(author)
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Accuracy of advanced versus strictly conventional 12-lead ECG for detection and screening of coronary artery disease, left ventricular hypertrophy and left ventricular systolic dysfunction
- 2010
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In: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 10
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Journal article (peer-reviewed)abstract
- Background: Resting conventional 12-lead ECG has low sensitivity for detection of coronary artery disease (CAD) and left ventricular hypertrophy (LVH) and low positive predictive value (PPV) for prediction of left ventricular systolic dysfunction (LVSD). We hypothesized that a similar to 5-min resting 12-lead advanced ECG test ("A-ECG") that combined results from both the advanced and conventional ECG could more accurately screen for these conditions than strictly conventional ECG. Methods: Results from nearly every conventional and advanced resting ECG parameter known from the literature to have diagnostic or predictive value were first retrospectively evaluated in 418 healthy controls and 290 patients with imaging-proven CAD, LVH and/or LVSD. Each ECG parameter was examined for potential inclusion within multi-parameter A-ECG scores derived from multivariate regression models that were designed to optimally screen for disease in general or LVSD in particular. The performance of the best retrospectively-validated A-ECG scores was then compared against that of optimized pooled criteria from the strictly conventional ECG in a test set of 315 additional individuals. Results: Compared to optimized pooled criteria from the strictly conventional ECG, a 7-parameter A-ECG score validated in the training set increased the sensitivity of resting ECG for identifying disease in the test set from 78% (72-84%) to 92% (88-96%) (P < 0.0001) while also increasing specificity from 85% (77-91%) to 94% (88-98%) (P < 0.05). In diseased patients, another 5-parameter A-ECG score increased the PPV of ECG for LVSD from 53% (41-65%) to 92% (78-98%) (P < 0.0001) without compromising related negative predictive value. Conclusion: Resting 12-lead A-ECG scoring is more accurate than strictly conventional ECG in screening for CAD, LVH and LVSD.
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| 3. |
- Starc, Vito, et al.
(author)
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Can functional cardiac age be predicted from the ECG in a normal healthy population?
- 2012
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In: Computing in Cardiology 2012, CinC 2012. - 9781467320740 ; 39, s. 101-104
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Conference paper (peer-reviewed)abstract
- We hypothesized that in a normal healthy population changes in several ECG parameters together might reliably characterize the functional age of the heart. Data from 377 healthy subjects (209 men, 168 women, aged 4 to 75 years) were included in the study. In all subjects, ECG recordings (resting 5-minute 12-lead high fidelity ECG) were evaluated via custom software programs to calculate up to 120 different conventional and advanced ECG parameters. Using factor analysis, those 5 parameters that exhibited the highest linear correlations with age and that were mutually the least correlated were evaluated by multiple linear regression analysis to predict the functional electrical age of the heart. Ignoring small differences between males and females, functional electrical age was best predicted (R2 of 0.76, P < 0.001) by multiple linear regression analysis incorporating the RR-interval normalized high frequency variability of RRV; the RR-interval normalized value of a QT variability parameter called QTcor; the mean high frequency QRS (150-250 Hz) amplitude; the mean ST segment level at the J point; and the body mass index. In apparently healthy subjects, functional cardiac age can be estimated by multiple linear regression analysis of mostly advanced ECG parameters.
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