Diagnostic body surface potential map patterns in left ventricular hypertrophy during PQRST

Kornreich, Frédéric; Montague, Terrence J.; Rautaharju, Pentti M.; Kavadias, Michail; Horacek, Milan; Taccardi, Bruno

doi:10.1016/0002-9149(89)90908-9

Cited by 17 publications

(9 citation statements)

References 25 publications

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“…Measuring only maximum QRS deflection amplitudes overlooks the more powerful discriminating and quantitation capabilities of information in other segments within the QRS complex. 12,29,30 Accordingly, the time-voltage integrated QRS area in the horizontal plane from the orthogonal signal-averaged ECG improves ECG detection of LVH, 9,10 and the sum of QRS areas in the 12-lead ECG results in further improvement of performance for LVH detection. 11 Importantly, the 12-lead QRS area sum may be relatively independent of extracardiac factors and gender.…”

Section: Bspm and 12-lead Ecg Detection And Quantitation Of Lvhmentioning

confidence: 95%

“…11 Even though the QRS area scans the temporal aspects of the depolarization wavefront, it is possible that the positioning of the electrodes in the 12-lead ECG is not spatially optimal for QRS area-based LVH detection. This is suggested by the distribution of most informative leads in BSPM outside the conventional 12-lead ECG electrode positioning 12,29,30 and by the fact that orthogonal ECG does not capture all the available information for the assessment of the activation wavefronts. 9,10,12,29,30 In addition, the T-wave may contain complementary information of LV mass, [12][13][14][15]29,30 but QRST areas have not been assessed for this purpose.…”

Section: Bspm and 12-lead Ecg Detection And Quantitation Of Lvhmentioning

confidence: 99%

“…9,10,12,29,30 In addition, the T-wave may contain complementary information of LV mass, [12][13][14][15]29,30 but QRST areas have not been assessed for this purpose. Methods developed for LVH detection utilizing the BSPM technique have improved the identification and even quantification of anatomic LVH, 12,[29][30][31][32][33][34] suggesting that accurate assessment of anatomic LVH from electrical signals is indeed possible.…”

Section: Bspm and 12-lead Ecg Detection And Quantitation Of Lvhmentioning

confidence: 99%

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Electrocardiographic assessment of left ventricular hypertrophy with time–voltage QRS and QRST-wave areas

et al. 2003

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The sum of time-voltage QRS areas in the 12-lead electrocardiogram (ECG) has outperformed other 12-lead ECG indices for detection of left ventricular hypertrophy (LVH). We assessed indices of time-voltage QRS and T-wave (QRST) areas from body surface potential mapping (BSPM) for detection of and quantitation of the degree of LVH. We studied 42 patients with echocardiographic LVH (LVH group) and 11 healthy controls (controls). QRST area sums were calculated from 123-lead BSPM and from the 12-lead ECG for comparison. Leadwise discriminant indices and correlation coefficients were used to identify optimal recording locations for QRST area-based LVH assessment. BSPM QRS area sum was greater in the LVH group than in controls (3752 7 1259 vs 2278 7 627 lV s, respectively; Po0.001) and at 91% specificity showed 74% sensitivity for LVH detection. The 12-lead QRS area sum performed similarly. Taking T-wave areas into account did not improve the results. QRS area sum from two most informative leads (located in the upper and lower right precordium) also separated the LVH group from controls (61.1 7 23.5 vs 27.8 7 6.5 lV s, respectively; Po0.00001). This 2-lead QRS area sum showed 90% sensitivity with 100% specificity for LVH detection and maintained high correlation to indexed left ventricular mass (r ¼ 0.732; Po0.001). In conclusion, the BSPM QRS area sum compared to 12-lead QRS area sum does not substantially improve LVH assessment. The 2-lead QRS area sum may improve ECG QRS area-based LVH assessment.

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Section: Bspm and 12-lead Ecg Detection And Quantitation Of Lvhmentioning

confidence: 95%

Section: Bspm and 12-lead Ecg Detection And Quantitation Of Lvhmentioning

confidence: 99%

Section: Bspm and 12-lead Ecg Detection And Quantitation Of Lvhmentioning

confidence: 99%

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Electrocardiographic assessment of left ventricular hypertrophy with time–voltage QRS and QRST-wave areas

et al. 2003

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“…Spatial characteristics of the body surface potential distribution do not alter during the development of LVH in rats (Hodgkin et al 1981; Bernadič & Zlatoš, 1996). In hypertensive patients with LVH, spatial characteristics of the body surface potential distribution during the initial ventricular activity are similar to those in non‐hypertensive humans; locations of the potential extrema are analogous (Igarashi et al 1987; Yamaki et al 1989; Kornreich et al 1989; Moroshkin et al 1995). The absence of changes in displacement of the areas and extrema of the body surface potential distribution may be explained by unaltered cardiac excitation sequence.…”

Section: Discussionmentioning

confidence: 89%

Depolarization pattern of ventricular epicardium in two‐kidney one‐clip hypertensive rats

Kharin

Krandycheva

Shmakov

2005

Experimental Physiology

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The present study is the first attempt to examine the effect of left ventricular hypertrophy (LVH) on the excitation pattern of the ventricular epicardium in experimental hypertensive rats. The left renal artery was clipped in Wistar rats (n = 8; 6-8 months old; weight, 174-295 g) to produce two-kidney one-clip (2K1C) hypertension. After 4 weeks, blood pressure was measured, and epicardial potential mapping was performed under sinus rhythm from 64 unipolar electrodes regularly distributed over the ventricular epicardium. Systolic blood pressure was ∼40% higher in the rats with a clipped renal artery (162 ± 14 mmHg, mean ± S.D.) than in the normotensive rats (115 ± 3 mmHg). LVH (∼23% increase in the ratio of the left ventricular weight to the body weight, P < 0.05) was observed in the 2K1C hypertensive rats. The depolarization pattern of the ventricular epicardium in the normotensive rats was similar to that in the rats with 2K1C hypertensive LVH. The duration of ventricular epicardial activation was shown to increase (∼35%, P < 0.05) in the hypertensive rats as compared to the normotensive animals. This study provides an explanation for alterations of the body surface potential distribution in hypertensive patients with LVH.

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“…if their signals are added to the 12-lead ECG signals [8,9]. If the sensitivity and specificity are increased by adding a lead, this lead contains essential information and should therefore be included in the lead system.…”

Section: Identification Of the Added Diagnostic Value Of A Selection mentioning

confidence: 99%

The Number of Independent Signals in Body Surface Maps

Hoekema

Uijen²,

Oosterom³

1999

Methods Inf Med

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This paper reports on the number of independent signals in body surface maps measured using a variety of lead systems incorporating 32 up to 219 leads. The number of independent signals is estimated using the minimum description length. It is found that the number of independent signals in body surface maps is of the order of 10. For lead systems incorporating many leads the number of independent signals is only marginally larger than in lead systems incorporating fewer leads. A lead system incorporating 64 leads will suffice for most applications.

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Diagnostic body surface potential map patterns in left ventricular hypertrophy during PQRST

Cited by 17 publications

References 25 publications

Electrocardiographic assessment of left ventricular hypertrophy with time–voltage QRS and QRST-wave areas

Electrocardiographic assessment of left ventricular hypertrophy with time–voltage QRS and QRST-wave areas

Depolarization pattern of ventricular epicardium in two‐kidney one‐clip hypertensive rats

The Number of Independent Signals in Body Surface Maps

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