Right precordial-directed electrocardiographical markers identify arrhythmogenic right ventricular cardiomyopathy in the absence of conventional depolarization or repolarization abnormalities
(2017) In BMC Cardiovascular Disorders 17(1).- Abstract
Background: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) carries a risk of sudden death. We aimed to assess whether vectorcardiographic (VCG) parameters directed toward the right heart and a measured angle of the S-wave would help differentiate ARVD/C with otherwise normal electrocardiograms from controls. Methods: Task Force 2010 definite ARVD/C criteria were met for all patients. Those who did not fulfill Task Force depolarization or repolarization criteria (-ECG) were compared with age and gender-matched control subjects. Electrocardiogram measures of a 3-dimentional spatial QRS-T angle, a right-precordial-directed orthogonal QRS-T (RPD) angle, a root mean square of the right sided depolarizing forces... (More)
Background: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) carries a risk of sudden death. We aimed to assess whether vectorcardiographic (VCG) parameters directed toward the right heart and a measured angle of the S-wave would help differentiate ARVD/C with otherwise normal electrocardiograms from controls. Methods: Task Force 2010 definite ARVD/C criteria were met for all patients. Those who did not fulfill Task Force depolarization or repolarization criteria (-ECG) were compared with age and gender-matched control subjects. Electrocardiogram measures of a 3-dimentional spatial QRS-T angle, a right-precordial-directed orthogonal QRS-T (RPD) angle, a root mean square of the right sided depolarizing forces (RtRMS-QRS), QRS duration (QRSd) and the corrected QT interval (QTc), and a measured angle including the upslope and downslope of the S-wave (S-wave angle) were assessed. Results: Definite ARVD/C was present in 155 patients by 2010 Task Force criteria (41.7 ± 17.6 years, 65.2% male). -ECG ARVD/C patients (66 patients) were compared to 66 control patients (41.7 ± 17.6 years, 65.2% male). All parameters tested except the QRSd and QTc significantly differentiated -ECG ARVD/C from control patients (p < 0.004 to p < 0.001). The RPD angle and RtRMS-QRS best differentiated the groups. Combined, the 2 novel criteria gave 81.8% sensitivity, 90.9% specificity and odds ratio of 45.0 (95% confidence interval 15.8 to 128.2). Conclusion: ARVD/C disease process may lead to development of subtle ECG abnormalities that can be distinguishable using right-sided VCG or measured angle markers better than the spatial QRS-T angle, the QRSd or QTc, in the absence of Taskforce ECG criteria.
(Less)
- author
- Cortez, Daniel
LU
; Svensson, Anneli
; Carlson, Jonas
LU
; Graw, Sharon ; Sharma, Nandita ; Brun, Francesca ; Spezzacatene, Anita ; Mestroni, Luisa and Platonov, Pyotr G. LU
- organization
- publishing date
- 2017-10-13
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Arrhythmogenic right ventricular cardiomyopathy, Cascade screening, ECG, Vectorcardiography
- in
- BMC Cardiovascular Disorders
- volume
- 17
- issue
- 1
- article number
- 261
- pages
- 10 pages
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:29029613
- wos:000412924700002
- scopus:85030985111
- ISSN
- 1471-2261
- DOI
- 10.1186/s12872-017-0696-x
- language
- English
- LU publication?
- yes
- id
- 6a15aa15-3144-4be6-82dd-8aed310f3455
- date added to LUP
- 2017-11-02 09:43:30
- date last changed
- 2025-01-07 23:52:42
@article{6a15aa15-3144-4be6-82dd-8aed310f3455, abstract = {{<p>Background: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) carries a risk of sudden death. We aimed to assess whether vectorcardiographic (VCG) parameters directed toward the right heart and a measured angle of the S-wave would help differentiate ARVD/C with otherwise normal electrocardiograms from controls. Methods: Task Force 2010 definite ARVD/C criteria were met for all patients. Those who did not fulfill Task Force depolarization or repolarization criteria (-ECG) were compared with age and gender-matched control subjects. Electrocardiogram measures of a 3-dimentional spatial QRS-T angle, a right-precordial-directed orthogonal QRS-T (RPD) angle, a root mean square of the right sided depolarizing forces (RtRMS-QRS), QRS duration (QRSd) and the corrected QT interval (QTc), and a measured angle including the upslope and downslope of the S-wave (S-wave angle) were assessed. Results: Definite ARVD/C was present in 155 patients by 2010 Task Force criteria (41.7 ± 17.6 years, 65.2% male). -ECG ARVD/C patients (66 patients) were compared to 66 control patients (41.7 ± 17.6 years, 65.2% male). All parameters tested except the QRSd and QTc significantly differentiated -ECG ARVD/C from control patients (p < 0.004 to p < 0.001). The RPD angle and RtRMS-QRS best differentiated the groups. Combined, the 2 novel criteria gave 81.8% sensitivity, 90.9% specificity and odds ratio of 45.0 (95% confidence interval 15.8 to 128.2). Conclusion: ARVD/C disease process may lead to development of subtle ECG abnormalities that can be distinguishable using right-sided VCG or measured angle markers better than the spatial QRS-T angle, the QRSd or QTc, in the absence of Taskforce ECG criteria.</p>}}, author = {{Cortez, Daniel and Svensson, Anneli and Carlson, Jonas and Graw, Sharon and Sharma, Nandita and Brun, Francesca and Spezzacatene, Anita and Mestroni, Luisa and Platonov, Pyotr G.}}, issn = {{1471-2261}}, keywords = {{Arrhythmogenic right ventricular cardiomyopathy; Cascade screening; ECG; Vectorcardiography}}, language = {{eng}}, month = {{10}}, number = {{1}}, publisher = {{BioMed Central (BMC)}}, series = {{BMC Cardiovascular Disorders}}, title = {{Right precordial-directed electrocardiographical markers identify arrhythmogenic right ventricular cardiomyopathy in the absence of conventional depolarization or repolarization abnormalities}}, url = {{http://dx.doi.org/10.1186/s12872-017-0696-x}}, doi = {{10.1186/s12872-017-0696-x}}, volume = {{17}}, year = {{2017}}, }