How are ECG parameters related to cardiac magnetic resonance images? Electrocardiographic predictors of left ventricular hypertrophy and myocardial fibrosis in hypertrophic cardiomyopathy

Dohy, Zsófia; Vereckei, András; Horváth, Viktor J.; Czimbalmos, Csilla; Szabó, L; Tóth, Attila; Suhai, Ferenc Imre; Csécs, Ibolya; Becker, Dávid; Merkely, Béla; Vágó, Hajnalka

doi:10.1111/anec.12763

Cited by 16 publications

(17 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies have reported that, in patients with hypertrophic cardiomyopathy, low QRS voltage is associated with cardiac fibrosis as assessed by magnetic resonance imaging. 11,12 Taken together, a high LVMI-to-QRS-voltage ratio is not simply a marker of identifying cardiac amyloidosis, but comprehensive marker of myocardial structural changes due to myocardial fibrosis and infiltration into the myocardium, which is helpful for risk stratification and understanding pathophysiology in heterogeneous patients with HFpEF.…”

Section: Discussionmentioning

confidence: 99%

“…Of 535 patients enrolled in the JASPER registry, the following patients were excluded: patients who died during their hospitalization (n = 7); patients without body surface area data, or echocardiogram during hospitalization (n = 16); patients without electrocardiogram (ECG) assessment during hospitalization (n = 206); and patients whose QRS voltage on ECG showed abnormal values (SV1 + RV5 ≥ 10 mV) that were not physiologically possible and assumed to be input errors (n = 16) considering previously reported studies. 11,12 A total of 290 patients were included in this analysis.…”

Section: Patient Recruitmentmentioning

confidence: 99%

See 1 more Smart Citation

Left ventricular mass index‐to‐QRS‐voltage ratio predicts outcomes in heart failure with preserved ejection fraction

et al. 2022

View full text Add to dashboard Cite

Aims Increased left ventricular mass index (LVMI) disproportionate to electrocardiographic QRS voltage has been reported to be associated with cardiac fibrosis and amyloid infiltration to myocardium. This study aimed to assess whether the LVMI-to-QRS-voltage ratio predicts clinical outcomes in heart failure with preserved ejection fraction (HFpEF). Methods and resultsThe Japanese Heart Failure Syndrome with Preserved Ejection Fraction (JASPER) registry is a nationwide, observational, and prospective registration of Japanese patients hospitalized with HFpEF (EF ≥ 50%). LVMI was assessed by echocardiography using the cube formula. QRS voltage was assessed by Sokolow-Lyon voltage criteria. We divided 290 patients in the registry who met inclusion criteria into five groups according to the quintile values of their LVMI-to-QRS-voltage ratio. In the highest quintile group (≥71.8 g/m 2 /mV), approximately 50% of the patients had concentric hypertrophy and 30% had eccentric hypertrophy. These patients had the highest proportion of atrial fibrillation (61.4%) and history of pacemaker implantation (12.1%) among the five groups (P < 0.05). During the mean follow-up of 587 ± 300 days, 31.4% of all patients met the composite endpoint of all-cause death or rehospitalization for HF. Even after adjustment for demographic and baseline variables, the highest quintile group had a significantly higher incidence of the composite endpoints than the lowest quintile group (<30.7 g/m 2 /mV) (hazard ratio: 2.205, 95% confidence interval: 1.106-4.395, P < 0.05). Conclusions A high LVMI-to-QRS-voltage ratio is independently associated with poor outcomes in patients with HFpEF.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Patient Recruitmentmentioning

confidence: 99%

Left ventricular mass index‐to‐QRS‐voltage ratio predicts outcomes in heart failure with preserved ejection fraction

et al. 2022

View full text Add to dashboard Cite

show abstract

“…With cardiac magnetic resonance imaging, fQRS has been shown to be associated with scar tissue in many cardiac diseases [27][28][29][30]. In patients with acromegaly, chronic excess of GH and IGF-1 secretion causes biventricular concentric hypertrophy and then interstitial fibrosis develops, which is accompanied by increased extracellular collagen deposition, lympho-mononuclear infiltrations, and myofibrillar derangement [31][32][33].…”

Section: Discussionmentioning

confidence: 99%

Assessment of fragmented QRS formation and its relationship with left ventricular hypertrophy in nonhypertensive acromegaly patients

et al. 2021

View full text Add to dashboard Cite

Background/aim: It is known that the presence of fragmented QRS (fQRS) on electrocardiography (ECG) is associated with cardiovascular events. The aim of this study was the evaluation of fQRS formation and its relationship with the left ventricular hypertrophy (LVH) parameters in acromegaly patients. Materials and methods:In total, 47 previously diagnosed with non-hypertensive acromegaly patients and 48 control subjects were included in the study. ECG and transthoracic echocardiography (TTE) were performed for each participant. Acromegaly patients were divided into two groups according to the fQRS formation on the ECG. Left ventricular wall thicknesses, and left atrial diameter (LAD), left ventricular mass (LVM), left ventricular mass index (LVMi), and relative wall thickness (RWT) were obtained. Results:In control group 5 (10.4%) and in acromegaly group 17 (36.2%) patients had fQRS on ECG (p = 0.003).

show abstract

“…Chemotherapeutic agents can trigger apoptosis or cause necrotic myocyte death. fQRS occurs when ventricular depolarization (VD) becomes abnormal and has been identified as an ECG biomarker of myocardial fibrosis and can be used to predict adverse cardiovascular events [ 12 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Electrocardiographic Characteristics of Breast Cancer Patients Treated with Chemotherapy

Liang

Wang

Yin

et al. 2020

Cardiology Research and Practice

View full text Add to dashboard Cite

Introduction. Patients receiving chemotherapy for breast cancer may be at risk of developing cardiac dysfunction and electrophysiological abnormalities. The aim of this study is to evaluate alterations in electrocardiographic (ECG) parameters in breast cancer patients receiving chemotherapy. Materials and Methods. This was a prospective single-center cohort study conducted in the Fourth Hospital of Hebei Medical University, China. Participants with breast cancer referred for chemotherapy from May 1, 2019, to October 1, 2019, were invited to participate in the study. Standard 12-lead ECG and echocardiography were performed at baseline or before chemotherapy (prechemotherapy) (T0), after 1 cycle (T1), after 3 cycles (T2), and at the end of chemotherapy (T3). Results. A total of 64 patients with diagnosed breast cancer undergoing chemotherapy were included. Echocardiographic parameters showed no significant variation during the entire procedure (all P > 0.05 ). The incidence of abnormal ECG increased from 43.75% at baseline to 65.63% at the end of chemotherapy, of which only the prevalence of fragmented QRS (fQRS) was significantly increased after the drug regimen (26.56% to 53.13%). At the end of the treatment, heart rate, P-wave dispersion, corrected QT interval, T-peak to T-end, RR, SV1, RV5, Sokolow–Lyon index (SLI), and index of cardioelectrophysiological balance deteriorated markedly (all P < 0.05 ). The area under the curve for SLI and QT dispersion (QTd) derived by ECG was 0.710 and 0.606, respectively. The cutoff value with 2.12 of SLI by ECG had a sensitivity of 67.2% and specificity of 71.9% for differentiating patients after therapy from baselines. The cutoff value with 0.55 of QTd had a sensitivity of 60.9% and specificity of 60.9%. Conclusions. The current study demonstrated that ECGs can be used to detect electrophysiological abnormalities in breast cancer patients receiving chemotherapy. ECG changes can reflect subclinical cardiac dysfunction before the echocardiographic abnormalities.

show abstract

How are ECG parameters related to cardiac magnetic resonance images? Electrocardiographic predictors of left ventricular hypertrophy and myocardial fibrosis in hypertrophic cardiomyopathy

Cited by 16 publications

References 41 publications

Left ventricular mass index‐to‐QRS‐voltage ratio predicts outcomes in heart failure with preserved ejection fraction

Left ventricular mass index‐to‐QRS‐voltage ratio predicts outcomes in heart failure with preserved ejection fraction

Assessment of fragmented QRS formation and its relationship with left ventricular hypertrophy in nonhypertensive acromegaly patients

Electrocardiographic Characteristics of Breast Cancer Patients Treated with Chemotherapy

Contact Info

Product

Resources

About