Advanced

Detection of hypertrophic cardiomyopathy is improved when using advanced rather than strictly conventional 12-lead electrocardiogram

Potter, Samara L. Poplack; Holmqvist, Fredrik LU ; Platonov, Pyotr LU ; Steding Ehrenborg, Katarina LU ; Arheden, Håkan LU ; Pahlm, Olle LU ; Starc, Vito; McKenna, William J. and Schlegel, Todd T. (2010) In Journal of Electrocardiology 43(6). p.713-718
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... (More)
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. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Sudden cardiac death, QRS-T angle, QT variability, Screening, Athletes' heart
in
Journal of Electrocardiology
volume
43
issue
6
pages
713 - 718
publisher
Elsevier
external identifiers
  • wos:000284514700042
  • scopus:78049470809
ISSN
1532-8430
DOI
10.1016/j.jelectrocard.2010.08.010
language
English
LU publication?
yes
id
ad5b06a3-44c9-4af8-a0f4-a7fe3de667b8 (old id 1752151)
date added to LUP
2011-01-04 07:44:13
date last changed
2018-05-29 11:02:27
@article{ad5b06a3-44c9-4af8-a0f4-a7fe3de667b8,
  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.},
  author       = {Potter, Samara L. Poplack and Holmqvist, Fredrik and Platonov, Pyotr and Steding Ehrenborg, Katarina and Arheden, Håkan and Pahlm, Olle and Starc, Vito and McKenna, William J. and Schlegel, Todd T.},
  issn         = {1532-8430},
  keyword      = {Sudden cardiac death,QRS-T angle,QT variability,Screening,Athletes' heart},
  language     = {eng},
  number       = {6},
  pages        = {713--718},
  publisher    = {Elsevier},
  series       = {Journal of Electrocardiology},
  title        = {Detection of hypertrophic cardiomyopathy is improved when using advanced rather than strictly conventional 12-lead electrocardiogram},
  url          = {http://dx.doi.org/10.1016/j.jelectrocard.2010.08.010},
  volume       = {43},
  year         = {2010},
}