Electrocardiographic left atrial abnormalities predict cardiovascular mortality

Ha, Le Dung; Grober, Aaron; Hock, Julia; Wheeler, Matthew T.; Elbadawi, Ayman; Biniwale, Nishit; Baig, Basarat; Froelicher, Victor F.

doi:10.1016/j.jelectrocard.2018.04.017

Cited by 7 publications

(9 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…13 Subjects with a P-wave duration >120 ms had a 21% greater risk of CV death compared to subjects with a P-wave duration ≤120 ms 13 Moreover, in a long-term study at the same center, in which subjects with a mean age of 43 years were followed for a median duration of 17 years, prolonged P-wave duration was associated with 1.53-3.08 fold in CV death. 11 The reason for the difference in hazard ratios between these previous studies and our present study might be that our present study population consisted of Japanese with CV risks, who were older than the subjects in the previous studies. Generally, P-wave duration is associated with age 19 and prolonged with aging.…”

Section: Discussioncontrasting

confidence: 63%

Automatically assessed P‐wave predicts cardiac events independently of left atrial enlargement in patients with cardiovascular risks: The Japan Morning Surge‐Home Blood Pressure Study

Yokota

Kabutoya

Hoshide

et al. 2020

J of Clinical Hypertension

View full text Add to dashboard Cite

show abstract

Section: Discussioncontrasting

confidence: 63%

Automatically assessed P‐wave predicts cardiac events independently of left atrial enlargement in patients with cardiovascular risks: The Japan Morning Surge‐Home Blood Pressure Study

Yokota

Kabutoya

Hoshide

et al. 2020

J of Clinical Hypertension

View full text Add to dashboard Cite

show abstract

“…Our models demonstrated better predictive capability for all-cause death (the mean c-statistics of 10 models was 0.881 ± 0.027 for the training dataset and 0.927 ± 0.101 for the testing dataset) and CV death (0.862 ± 0.029 for the training model and 0.897 ± 0.069 for the testing model) than previous studies that used a few ECG parameters, in which the c-statistics for predicting death were 0.58 (maximal P wave duration) [22], 0.64 (minimal P′ amplitude in lead V1 and V2) [22], 0.61 (QRS area) [23], 0.55 (QRS morphology) [23], 0.51 (QRS duration) [23], 0.727 (QRS-T angle), [24] and 0.759 (model including clinical variables, such as age, sex, hypertension, diabetes, and ECG parameters) [6]. Not surprisingly, the high predictive capabilities of our models are due to the use of a large number of ECG parameters as consecutive values and the application of machine learning, which may sacrifice simplicity but prioritize the predictive capability [11].…”

Section: Comparison With Previous Studies and Clinical Implications Omentioning

confidence: 57%

Relationship between resting 12-lead electrocardiogram and all-cause death in patients without structural heart disease: Shinken Database analysis

Hirota

Suzuki

Arita

et al. 2021

BMC Cardiovasc Disord

View full text Add to dashboard Cite

Background Resting 12-lead electrocardiography is widely used for the detection of cardiac diseases. Electrocardiogram readings have been reported to be affected by aging and, therefore, can predict patient mortality. Methods A total of 12,837 patients without structural heart disease who underwent electrocardiography at baseline were identified in the Shinken Database among those registered between 2010 and 2017 (n = 19,170). Using 438 electrocardiography parameters, predictive models for all-cause death and cardiovascular (CV) death were developed by a support vector machine (SVM) algorithm. Results During the observation period of 320.4 days, 55 all-cause deaths and 23 CV deaths were observed. In the SVM prediction model, the mean c-statistics of 10 cross-validation models with training and testing datasets were 0.881 ± 0.027 and 0.927 ± 0.101, respectively, for all-cause death and 0.862 ± 0.029 and 0.897 ± 0.069, respectively for CV death. For both all-cause and CV death, high values of permutation importance in the ECG parameters were concentrated in the QRS complex and ST-T segment. Conclusions Parameters acquired from 12-lead resting electrocardiography could be applied to predict the all-cause and CV deaths of patients without structural heart disease. The ECG parameters that greatly contributed to the prediction were concentrated in the QRS complex and ST-T segment.

show abstract

“…Third was the Stanford clinical study 10 that included 20 827 veterans younger than 56 years of age who underwent ECGs at a Veteran's Affairs Medical Center from 1987 to 1999, followed for a median duration of 17.8 years for CVD. Cox Hazard analyses were applied, with adjustment for age, sex, and ECG abnormalities.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 In recent work, we found in a clinical population of 20 827 young veterans (mean age 44) followed for a median duration of 17.8 years an association between ECG-LAA and cardiovascular death (CVD) after age adjustment [hazard ratio (HR): 2.9-4.1]. 10 In this work, we (1) describe P wave patterns and measurements in a large population of individuals being screened for competitive sports participation and (2) compare the IEC for LAE in young competitive athletes to the Stanford criteria for ECG-LAA. Our retrospective findings are hypothesis generating and require validation in a large prospective athlete follow-up study.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of the Stanford ECG Left Atrial Criteria With the International ECG Criteria for Sports Screening

Hock

Wheeler

Singh

et al. 2019

Clinical Journal of Sport Medicine

Self Cite

View full text Add to dashboard Cite

Objective:Because the International left atrial enlargement electrocardiographic (ECG) screening criteria (ECG-LAE) for athletes are rarely fulfilled in young athletes, we compared it with evidence-based criteria from a recent clinical outcome study of ECG left atrial abnormality (ECG-LAA).Design:Retrospective analyses.Setting:Routine preparticipation ECG screening in California.Participants:Four thousand four hundred thirty-eight young individuals (18.5 ± 5.4 years, 40% women).Assessment of Risk Factors:The International criteria for ECG-LAE were applied: prolonged P wave duration of ≥120 ms in leads I or II AND negative portion of ≥1 mm in depth in lead V1. This was compared with Stanford criteria for ECG-LAA: prolonged P wave duration of ≥140 ms odds ratio (OR) negative portion in V1 and V2 greater than 1 mm.Main Outcome Measures:Differences in the classification of abnormal ECGs between the 2 criteria applied to the same population of young athletes.Results:Only 33 (0.7%) of our subjects fulfilled the International criteria for ECG-LAE while 110 (2.5%) fulfilled the ECG-LAA criteria. Adding our new ECG-LAA criterion and considering it a major criterion raised the abnormal ECG prevalence and athletes referred for further evaluation from 2.9% to 4.4%.Conclusions:The Stanford evidence-based criterion for ECG-LAA incorporating V2 and replacing “or” for “and” regarding P wave duration increased the yield of abnormal classification for P waves. Future follow-up studies are needed to confirm that this new criterion should be included in future ECG screening consensus documents.

show abstract

Electrocardiographic left atrial abnormalities predict cardiovascular mortality

Cited by 7 publications

References 20 publications

Automatically assessed P‐wave predicts cardiac events independently of left atrial enlargement in patients with cardiovascular risks: The Japan Morning Surge‐Home Blood Pressure Study

Automatically assessed P‐wave predicts cardiac events independently of left atrial enlargement in patients with cardiovascular risks: The Japan Morning Surge‐Home Blood Pressure Study

Relationship between resting 12-lead electrocardiogram and all-cause death in patients without structural heart disease: Shinken Database analysis

Comparison of the Stanford ECG Left Atrial Criteria With the International ECG Criteria for Sports Screening

Contact Info

Product

Resources

About