Assessment of left ventricular function from the electrocardiogram in left bundle branch block

Recke, Siegfried H.; Esperer, Hans D.; Eberlein, U.; Gansser, Rolf; Emde, J. von der

doi:10.1016/0167-5273(89)90008-9

Cited by 10 publications

(1 citation statement)

References 15 publications

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“…Th erefore the R-peak delay as a sign of myocardial function-conduction impairment should not be erroneously regarded as complete LBBB. In contrast to the fi ndings of the present study, the QRS durations of patients with chronic aortic valve disease and ECG-documented LBBB were found to be 157.4 ± 17.5 ms, and in a total population of 165 patients with complete LBBB and various heart diseases only a QRS duration greater than 150 ms was reported to be of diagnostic value in predicting declining EF <55% (sensitivity 81%, specifi city 72.5%, negative predictive value 86%) [11]. Th erefore in patients with LBBB, the QRS durations are clearly above the values presented by the patients of this study.…”

Section: Discussioncontrasting

confidence: 85%

Left ventricular function-conduction impairment as reflected by the ECG in chronic aortic regurgitation

Recke

2011

Wien Klin Wochenschr

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The study was conducted to ascertain that the ECG assists in the assessment of systolic dysfunction in chronic aortic regurgitation. Five variables were reviewed in 146 adults without bundle branch block who underwent angiocardiography: total 12-lead QRS amplitude, QRS duration, maximum R peak time in I, V5 or V6, maximum R peak time relative to S peak time of the maximum S in V1, V2 or V3, and maximum T wave amplitude and polarity in I, V6 or aVF. In order to define which of them could differentiate left ventricular ejection fraction (EF) ≥50% (n = 101) from EF <50% (n = 45) they were subjected to stepwise linear discriminant analysis. The maximum R peak time relative to S peak time emerged as the most promising variable. In predicting EF <50%, R peak time prolongation exceeding S peak time, i.e. R peak delay, yields reliable results, with specificity, positive and negative predictive value being 89.1%, 70.3% and 82.6%, respectively, and sensitivity being 57.8%. As given by the sample odds-ratio, R peak delay indicates an 11-fold increased risk of having EF <50%. R peak delay, a marker of left ventricular function-conduction impairment identifies patients who need valve replacement.

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Section: Discussioncontrasting

confidence: 85%

Left ventricular function-conduction impairment as reflected by the ECG in chronic aortic regurgitation

Recke

2011

Wien Klin Wochenschr

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Non-Q-Elektrokardiogramme

Recke¹

2012

Med Klin Intensivmed Notfmed

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An increasing number of elderly people and diabetes patients with myocardial infarction go unrecognized because of painless ischemia and regression of major Q-waves over time. An increased awareness of diagnostic electrocardiogram (ECG) abnormalities other than Q-waves should allow physicians to optimize patient management. Particularly emphasized is the R-peak delay in V6, i.e. the R-peak in V6 being later than the S-peak in V2, as a sign of masked anterior myocardial infarction and ECG findings if infarcts are masked by left ventricular hemiblocks and left bundle branch block (LBBB). In left anterior hemiblocks dramatically decreased R-waves in leads II, III and AVF in conjunction with disappearance of Q-waves in leads I and aVL help to identify posterodiaphragmatic infarction. The left posterior hemiblock is itself a potent indicator of underlying posterodiaphragmatic infarction not recognized by Q-waves. In LBBB Cabrera's sign, RSR' morphology in the left-sided or inferior leads, inverse R-progression from V1 to V3 and primary repolarization abnormalities overlying the secondary T-wave changes are specific indicators of myocardial infarction. QRS-prolongation greater than 150 ms independently identifies ventricular function impairment in chronic coronary heart disease.

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Importance of the standard electrocardiogram in ambulatory (Holter) electrocardiography

Kennedy

1992

American Heart Journal

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Assessment of left ventricular function from the electrocardiogram in left bundle branch block

Cited by 10 publications

References 15 publications

Left ventricular function-conduction impairment as reflected by the ECG in chronic aortic regurgitation

Left ventricular function-conduction impairment as reflected by the ECG in chronic aortic regurgitation

Non-Q-Elektrokardiogramme

Importance of the standard electrocardiogram in ambulatory (Holter) electrocardiography

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