Clinical Significance of Low Voltage in Asymptomatic Patients With Pericardial Effusion Free of Heart Disease

Kudo, Yoshihisa; Yamasaki, Fumiyasu; Doi, Tadafumi; Doi, Yoshinori; Sugiura, Tetsuro

doi:10.1378/chest.124.6.2064

Cited by 16 publications

(4 citation statements)

References 17 publications

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“…Detection of low QRS voltages is common finding in a variety of pathological cardiac and non-cardiac conditions that have extensively been described in previous decade. 1–9 Recently, however, a new interest has been growing in LQRSVs in the multiparametric diagnosis of ACM, emphasising this finding as a potential early marker of the disease. 10 Indeed, low ECG voltages in ACM patients have been reported to predict adverse clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

“…Low QRS voltages (LQRSVs) have been exhaustively reported as an electrocardiographic feature in several cardiac and non-cardiac pathological conditions. 1–9 Recently, a novel interest in LQRSV was prompted by the observation that electrocardiogram (ECG) voltage reduction may be present in patients with arrhythmogenic cardiomyopathy (ACM). 10,11 Specifically, LQRSV was found to be a marker of the biventricular variant of ACM, and predict the presence of left ventricle involvement with significant fibrofatty myocardial replacement and scar.…”

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confidence: 99%

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Low QRS voltages in Olympic athletes: Prevalence and clinical correlates

Mango¹,

Caselli

Luchetti³

et al. 2020

Eur J Prev Cardiolog

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Background Recently, novel interest in low QRS voltages was prompted by the observation that low QRS voltages are present in arrhythmogenic cardiomyopathy patients, even before occurrence of symptoms/events. Aim The purpose of this study was to assess prevalence and clinical correlates of low QRS voltages in Olympic athletes, evaluated and followed-up within our cardiovascular screening programme. Methods Five hundred and sixteen athletes consecutively examined (2010–2011) were included in this study. A low QRS voltage was defined as amplitude of QRS <0.5 mV in limb and/or <1.0 mV in precordial leads. Cardiovascular evaluation included 12-lead and exercise electrocardiogram, echocardiography and, selectively, additional tests to conﬁrm diagnosis. Athletes were followed-up for 5 ± 2 (1–9) years. Results The majority of athletes (493; 96%) showed normal/increased R/S-wave voltages, but 23 (4%) had low QRS voltages. No differences were observed in low QRS voltage athletes compared to normal/increased QRS voltages for QRS duration, QTc and PR intervals, left ventricular cavity size and mass, or gender and sport participated. However, premature ventricular beats, occurred more frequently in low QRS voltages (39% vs 7%; p < 0.001), with patterns suggesting origin from left or right free wall. No diseases or events were registered in low QRS voltage athletes over the follow-up. Conclusions In Olympic athletes, the prevalence of low QRS voltages was 4%. Athletes with low QRS voltages did not differ from other athletes according to sport participated in or cardiac dimensions. However, more frequently (39% vs 7%) they showed premature ventricular beats, originating from either the left or right free ventricular wall. Therefore, long-term follow-up with serial clinical evaluations is needed in low QRS voltage athletes, in order to definitely clarify the clinical significance.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Low QRS voltages in Olympic athletes: Prevalence and clinical correlates

Mango¹,

Caselli

Luchetti³

et al. 2020

Eur J Prev Cardiolog

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“…Common cardiovascular signs of hypothyroidism include bradycardia, diastolic hypertension, narrowed pulse pressure, pericardial effusion (PE) and low voltage of the surface electrocardiogram (ECG) [1,2,3,4,5]. Echocardiography demonstrates small or moderate PE in up to one third of hypothyroid patients [1,2,3,4,5], but low voltage is not specific or sensitive enough to diagnose the presence of PE [2,6,7,8,9]. In our earlier study, we found that even a small PE associated with malignancy or a connective tissue disease caused low voltage on the surface ECG [9].…”

Section: Introductionmentioning

confidence: 99%

“…Echocardiography demonstrates small or moderate PE in up to one third of hypothyroid patients [1,2,3,4,5], but low voltage is not specific or sensitive enough to diagnose the presence of PE [2,6,7,8,9]. In our earlier study, we found that even a small PE associated with malignancy or a connective tissue disease caused low voltage on the surface ECG [9]. Because only a few studies with a limited number of patients have investigated the association between PE and low voltage in patients with primary hypothyroidism, we designed a study to determine the clinical correlates of PE and low voltage in patients with primary hypothyroidism.…”

Section: Introductionmentioning

confidence: 99%

Link between Pericardial Effusion and Attenuation of QRS Voltage in Patients with Hypothyroidism

Yamanaka¹,

Kumon²,

Matsumura

et al. 2010

Cardiology

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Objectives: To determine the clinical correlates of peri- cardial effusion (PE) and a low-voltage electrocardiogram (ECG) in patients with primary hypothyroidism. Methods: ECG, echocardiography and blood tests, including thyroid function tests, were performed in 64 consecutive patients with primary hypothyroidism. Results: Twenty-four patients (38%) had PE and 16 patients (25%) had low voltage. To determine the important variables present in patients with hypothyroidism that may be related to PE, 3 variables (free T4, pulmonary artery systolic pressure and serum albumin) were used in the multivariate analysis. From the analysis, free T4 (odds ratio = 0.032) and pulmonary artery systolic pressure (odds ratio = 1.085) emerged as significant variables related to PE, whereas when 4 variables (free T4, serum albumin, pulmonary artery systolic pressure and PE) were used to determine the important variables related to low voltage, free T4 (odds ratio = 0.029) and serum albumin (odds ratio = 0.255) were the significant variables, but PE had no significant relation with low voltage (p = 0.424). Conclusions: In addition to its association with more severe thyroid hormone deficiency, the presence of PE was also associated with an increase in pulmonary artery pressure, whereas attenuation of QRS voltage was associated with lower colloid osmotic pressure in patients with hypothyroidism.

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