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The spatial QRS-T angle outperforms the Italian and Seattle ECG-based criteria for detection of hypertrophic cardiomyopathy in pediatric patients

Cortez, Daniel LU ; Sharma, Nandita; Cavanaugh, Jean; Tuozo, Froilan; Derk, Gwendolyn; Lundberg, Emily; Schlegel, Todd T; Weiner, Keith; Kiciman, Nafiz and Alejos, Juan, et al. (2015) In Journal of Electrocardiology 48(5). p.826-833
Abstract

Introduction The spatial peaks QRS-T angle has been shown to differentiate adult patients with hypertrophic cardiomyopathy (HCM) from controls. We hypothesized that the spatial peaks QRS-T angle would, in isolation, be more accurate than the Italian 12-lead ECG Pre-participation Screening criteria or the Seattle criteria for detecting hypertrophic cardiomyopathy (HCM) in pediatric patients. Methods A retrospective study of pediatric patients with HCM compared to age and gender-matched control patients was undertaken. Significance, odds ratios, sensitivity and specificity of HCM detection of the visually derived spatial peaks QRS-T angle were compared to those of traditional 12-lead ECG criteria using: 1) Italy's National... (More)

Introduction The spatial peaks QRS-T angle has been shown to differentiate adult patients with hypertrophic cardiomyopathy (HCM) from controls. We hypothesized that the spatial peaks QRS-T angle would, in isolation, be more accurate than the Italian 12-lead ECG Pre-participation Screening criteria or the Seattle criteria for detecting hypertrophic cardiomyopathy (HCM) in pediatric patients. Methods A retrospective study of pediatric patients with HCM compared to age and gender-matched control patients was undertaken. Significance, odds ratios, sensitivity and specificity of HCM detection of the visually derived spatial peaks QRS-T angle were compared to those of traditional 12-lead ECG criteria using: 1) Italy's National Pre-participation Screening Programme criteria; and 2) described criteria from Seattle. Results ECG results from 130 pediatric HCM patients (14.2 ± 4.4 years) were compared to 470 control patients (normal echocardiograms, mean age 13.4 ± 4.6 years). Mean ± standard deviation (SD) values for spatial peaks QRS-T angles were 120.4 ± 40.7 and 21.3 ± 13.7 degrees for HCM and controls, respectively (P < 0.001). A spatial peaks QRS-T angle cutoff value of > 54.9 degrees yielded greater sensitivity and specificity (93.1% and 98.7%, respectively) for detecting HCM over ECG criteria from Italy (68.5% and 48.1%, respectively) or Seattle (64.6% and 78.9%, respectively) with odds ratios at 1039.70 (95% CI 363.03 to 2977.67), 2.01 (95% CI 1.33 to 3.04) and 6.84 (4.49-10.44), respectively. Conclusion In our cohort, a visually derived spatial peaks QRS-T angle has increased sensitivity and specificity for detection of HCM in pediatric patients compared to currently utilized Italian or Seattle ECG criteria.

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publication status
published
keywords
Italian criteria, Screening, Seattle criteria, Vectorcardiography
in
Journal of Electrocardiology
volume
48
issue
5
pages
8 pages
publisher
Elsevier
external identifiers
  • scopus:84941314078
ISSN
0022-0736
DOI
10.1016/j.jelectrocard.2015.07.016
language
English
LU publication?
no
id
4f89c752-f6c4-4c27-bc4d-82b98f4ee02e
date added to LUP
2017-08-29 12:07:47
date last changed
2017-11-14 09:51:22
@article{4f89c752-f6c4-4c27-bc4d-82b98f4ee02e,
  abstract     = {<p>Introduction The spatial peaks QRS-T angle has been shown to differentiate adult patients with hypertrophic cardiomyopathy (HCM) from controls. We hypothesized that the spatial peaks QRS-T angle would, in isolation, be more accurate than the Italian 12-lead ECG Pre-participation Screening criteria or the Seattle criteria for detecting hypertrophic cardiomyopathy (HCM) in pediatric patients. Methods A retrospective study of pediatric patients with HCM compared to age and gender-matched control patients was undertaken. Significance, odds ratios, sensitivity and specificity of HCM detection of the visually derived spatial peaks QRS-T angle were compared to those of traditional 12-lead ECG criteria using: 1) Italy's National Pre-participation Screening Programme criteria; and 2) described criteria from Seattle. Results ECG results from 130 pediatric HCM patients (14.2 ± 4.4 years) were compared to 470 control patients (normal echocardiograms, mean age 13.4 ± 4.6 years). Mean ± standard deviation (SD) values for spatial peaks QRS-T angles were 120.4 ± 40.7 and 21.3 ± 13.7 degrees for HCM and controls, respectively (P &lt; 0.001). A spatial peaks QRS-T angle cutoff value of &gt; 54.9 degrees yielded greater sensitivity and specificity (93.1% and 98.7%, respectively) for detecting HCM over ECG criteria from Italy (68.5% and 48.1%, respectively) or Seattle (64.6% and 78.9%, respectively) with odds ratios at 1039.70 (95% CI 363.03 to 2977.67), 2.01 (95% CI 1.33 to 3.04) and 6.84 (4.49-10.44), respectively. Conclusion In our cohort, a visually derived spatial peaks QRS-T angle has increased sensitivity and specificity for detection of HCM in pediatric patients compared to currently utilized Italian or Seattle ECG criteria.</p>},
  author       = {Cortez, Daniel and Sharma, Nandita and Cavanaugh, Jean and Tuozo, Froilan and Derk, Gwendolyn and Lundberg, Emily and Schlegel, Todd T and Weiner, Keith and Kiciman, Nafiz and Alejos, Juan and Landeck, Bruce and Aboulhosn, Jamil and Miyamoto, Shelley and Batra, Anjan S. and McCanta, Anthony C.},
  issn         = {0022-0736},
  keyword      = {Italian criteria,Screening,Seattle criteria,Vectorcardiography},
  language     = {eng},
  month        = {09},
  number       = {5},
  pages        = {826--833},
  publisher    = {Elsevier},
  series       = {Journal of Electrocardiology},
  title        = {The spatial QRS-T angle outperforms the Italian and Seattle ECG-based criteria for detection of hypertrophic cardiomyopathy in pediatric patients},
  url          = {http://dx.doi.org/10.1016/j.jelectrocard.2015.07.016},
  volume       = {48},
  year         = {2015},
}