The Diagnostic Performance of Computer Programs for the Interpretation of Electrocardiograms

Willems, J. L.; Abreu-Lima, Cassiano; Arnaud, Pierre; Vanbemmel, Jh.; Brohet, Christian; Degani, R.; Denis, B; Gehring, J.; Graham, Ian D.; Vanherpen, G.; Machado, Hilário Bastos; Macfarlane, P. W.; Michaelis, Jörg; Sd, Moulopoulos; Rubel, P.; Zywietz, C.

doi:10.1056/nejm199112193252503

Cited by 467 publications

(155 citation statements)

References 25 publications

Supporting

Mentioning

145

Contrasting

Unclassified

Order By: Relevance

“…The QT interval was calculated from the beginning of the QRS complex to the end of the T wave, using the validated Sicard 440/740 ECG computer-analysis programme (Megacart version 3 V4, 7/2.38/23; Siemens Elema) [25,26]. The QT intervals were then corrected for heart rate to obtain the QTc value using Bazett's formula [27].…”

Section: Methodsmentioning

confidence: 99%

The impact of metabolic control and QTc prolongation on all-cause mortality in patients with type 2 diabetes and foot ulcers

Fagher

Löndahl

2013

Diabetologia

View full text Add to dashboard Cite

Aims/hypothesis The increased all-cause mortality in patients with chronic diabetic foot ulcers cannot fully be explained by traditional cardiovascular risk factors. The significance of heart-rate-corrected QT (QTc) prolongation, a finding often seen in these patients, is unknown. Recently, the importance of metabolic control and hypoglycaemia has been discussed. The aim of this study was to evaluate the impact of different HbA 1c levels and QTc prolongation on all-cause mortality in the high-risk population of patients with type 2 diabetes mellitus and foot ulcers. Methods All patients with type 2 diabetes, younger than 80 years, visiting our diabetes foot unit, with a foot ulcer duration >4 weeks, were screened for participation. Patients on dialysis were excluded. Patients were grouped according to HbA 1c level and QTc time ≤ or >440 ms. Results Patients (n=214, median age 69.1 years) were grouped according to HbA 1c level (HbA 1c <7.5% [<58 mmol/mol] n=81, 7.5-8.9% [58-74 mmol/mol] n=70, >8.9% [>74 mmol/ mol] n=63). Baseline characteristics, including use of potential hypoglycaemic drugs, were similar between groups. During the 8 years of follow-up 151 patients died (70.6%) and HbA 1c < 7.5% (<58 mmol/mol) was strongly associated with increased mortality. The highest mortality was seen in patients with a combination of HbA 1c <7.5% (<58 mmol/mol) and QTc prolongation, with an 8 year mortality of 92.1% as compared with 48.8% in those with HbA 1c < 7.5% (<58 mmol/mol) but without QTc prolongation. Conclusion/interpretations HbA 1c <7.5% (<58 mmol/mol) in a high-risk population of patients with type 2 diabetes and foot ulcers is associated with a significantly higher mortality, particularly in patients with QTc prolongation.

show abstract

Section: Methodsmentioning

confidence: 99%

The impact of metabolic control and QTc prolongation on all-cause mortality in patients with type 2 diabetes and foot ulcers

Fagher

Löndahl

2013

Diabetologia

View full text Add to dashboard Cite

show abstract

“…16,17 The presence of a possible or definite myocardial infarction on the ECG was used as an indicator of presence of coronary artery disease. 18 Information on medical history of myocardial infarction, medical history, drug use, and smoking was obtained by a trained research assistant using a computerized questionnaire, which includes a Dutch version of the Rose questionnaire to determine the presence of angina pectoris and intermittent claudication.…”

Section: Cardiovascular Assessmentmentioning

confidence: 99%

Serum Total IGF-I, Free IGF-I, and IGFBP-1 Levels in an Elderly Population

Janssen

Stolk

Pols

et al. 1998

ATVB

220

148

View full text Add to dashboard Cite

Abstract-Recently, a method to measure free insulin-like growth factor-I (IGF-I) levels has been developed. Free IGF-I levels may have greater physiological and clinical relevance than total (bound and free) IGF-I. The associations between the circulating IGF-I/IGF binding protein (IGFBP) system and cardiovascular disorders was studied. In a cross-sectional study of 218 healthy persons (103 men, 115 women) aged 55 to 80 years, fasting serum (total and free) IGF-I and IGFBP-1 levels, lipid profile, insulin, and glucose were measured. In addition, blood pressure, body mass index (BMI), and waist-hip ratio (WHR) were measured. Ultrasonography of both carotid arteries was performed to investigate the presence of atherosclerotic lesions. A history of angina pectoris, the presence of a possible or definite myocardial infarction on the ECG, and plaques in the carotid arteries were used as indicators of presence of cardiovascular signs and symptoms. Free IGF-I was inversely related to serum triglycerides (Pϭ.04, adjusted for age and sex). Mean free IGF-I levels in subjects without signs or symptoms of cardiovascular diseases were significantly higher than in those with at least one cardiovascular symptom or sign (Pϭ.002, adjusted for age and sex). Free IGF-I levels were also higher in subjects who had no atherosclerotic plaques in the carotid arteries (Pϭ.02, adjusted for age and sex) and who had never smoked (Pϭ.02, adjusted for age and sex). IGFBP-1 showed an inverse relation with insulin, BMI, and WHR and a positive relation with HDL cholesterol. The associations between IGFBP-1 levels and HDL cholesterol, WHR, and BMI remained significant after adjustment for fasting insulin levels. High fasting serum free IGF-I levels are associated with a decreased presence of atherosclerotic plaques and coronary artery disease and lower serum triglycerides, whereas high fasting IGFBP-1 levels are associated with a more favorable cardiovascular risk profile. The findings suggest that the IGF-I/IGFBP system is related to cardiovascular risk factors and atherosclerosis. (Arterioscler Thromb Vasc Biol. 1998;18:277-282.)

show abstract

Section: Introductionmentioning

confidence: 99%

“…Electrocardiographs that perform sophisticated signal processing and diagnostic interpretation of signals are today wide-spread [1]. Artificial neural networks (ANN's) are one of the most recent techniques in this field and have primarily been considered for classification of ECG's into different diagnostic groups [1], [2]. It has been shown that ANN's for specific issues can perform better than both experienced cardiologists and ruled-based criteria, e.g., in detecting acute myocardial infarction from the ECG [3].…”

Section: Introductionmentioning

confidence: 99%

Clustering ECG complexes using Hermite functions and self-organizing maps

Lagerholm

Peterson

Braccini

et al. 2000

IEEE Trans. Biomed. Eng.

472

267

View full text Add to dashboard Cite

Abstract-An integrated method for clustering of QRS complexes is presented which includes basis function representation and self-organizing neural networks (NN's). Each QRS complex is decomposed into Hermite basis functions and the resulting coefficients and width parameter are used to represent the complex. By means of this representation, unsupervised self-organizing NN's are employed to cluster the data into 25 groups. Using the MIT-BIH arrhythmia database, the resulting clusters are found to exhibit a very low degree of misclassification (1.5%). The integrated method outperforms, on the MIT-BIH database, both a published supervised learning method as well as a conventional template cross-correlation clustering method.

show abstract

The Diagnostic Performance of Computer Programs for the Interpretation of Electrocardiograms

Abstract: Our study shows that some but not all computer programs for the interpretation of ECGs perform almost as well as cardiologists in identifying seven major cardiac disorders.

Cited by 467 publications

References 25 publications

The impact of metabolic control and QTc prolongation on all-cause mortality in patients with type 2 diabetes and foot ulcers

The impact of metabolic control and QTc prolongation on all-cause mortality in patients with type 2 diabetes and foot ulcers

Serum Total IGF-I, Free IGF-I, and IGFBP-1 Levels in an Elderly Population

Clustering ECG complexes using Hermite functions and self-organizing maps

Contact Info

Product

Resources

About