Correlation of Precordial Voltages to Left Ventricular Mass on Echocardiogram in Adolescent Patients With Hypertrophic Cardiomyopathy Compared With that in Adolescent Athletes

Guerrier, Karine; Anderson, Jeffrey B.; Pratt, Jesse; King, Eileen; Statile, Christopher; Wilmot, Ivan; Campbell, Matthew; Czosek, Richard J.

doi:10.1016/j.amjcard.2015.01.025

Cited by 11 publications

(12 citation statements)

References 21 publications

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“…In contrast 30% of patients with HCM exhibited ST-segment depression. ST-segment depression has been shown to be very prevalent in patients with HCM26 29 and warrants further investigation if found in asymptomatic athletes.…”

Section: Discussionmentioning

confidence: 94%

Electrocardiographic abnormalities in elite high school athletes: comparison to adolescent hypertrophic cardiomyopathy

et al. 2016

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BackgroundIn athletes, ECG changes from physiological cardiac remodelling are common but can overlap with findings from a pathological disorder. We compared ECG findings in a group of elite high school athletes to a cohort of adolescents with hypertrophic cardiomyopathy (HCM).Methods/resultsWe prospectively performed 15-lead ECGs and echocardiograms in 147 elite high school athletes. Student-athlete ECGs were compared in blinded fashion to ECGs of 148 adolescents with HCM of similar age and ethnicity. Standard ECG hypertrophy criteria and established expert opinion guidelines (European Society of Cardiology, ESC and Seattle criteria) were analysed. All student-athletes had normal echocardiograms. Overall, 77/147 (52%) of student-athletes met standard ECG criteria for ventricular hypertrophy compared to 126/148 (85%) adolescents with HCM (p<0.0001). There were 112/148 (76%) adolescents with HCM who had pathological Q-waves, T-wave inversion and/or ST-segment depression compared to 1/147 (1%) athletes (p<0.0001). Most patients with HCM (84%, 124/148) had ≥1 abnormal ECG finding(s) according to Seattle criteria, compared to 1% of student-athletes (2/147). Similarly, 130/148 (88%) patients with HCM met group-2 ESC criteria (abnormal), compared to 36/147 (24%) student-athletes (p<0.0001).ConclusionsOver 50% of elite high school athletes with echocardiographically confirmed normal hearts satisfied standard voltage criteria for ventricular hypertrophy. Pathological Q-waves, T-wave inversion or ST-segment depression were most helpful in distinguishing adolescents with HCM from normals. Both ESC and Seattle criteria successfully stratified the student-athlete and HCM cohorts, however each had a false-negative rate >10% for the HCM cohort. The Seattle criteria demonstrated a significantly lower false-positive rate (1%) than the ESC criteria (24%).

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Section: Discussionmentioning

confidence: 94%

Electrocardiographic abnormalities in elite high school athletes: comparison to adolescent hypertrophic cardiomyopathy

et al. 2016

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“…The healthy control cohort was derived from a cardiac screening study in adolescent athletes previously described . A control group was chosen at random from ECG samples obtained from the prior adolescent screening study .…”

Section: Methodsmentioning

confidence: 99%

“…In evaluating the potential effectiveness of electrocardiogram (ECG) as a screening modality for HCM, commonly cited literature estimates that 90% of individuals with HCM have an abnormal ECG . These ECGs are abnormal in stereotypical ways, such as pathologic voltage, Q waves, ST changes, or T‐wave inversion . The Seattle Criteria, established by experts as the standard of preparticipation screening criteria, demonstrated 100% sensitivity with only a 4% false positive rate in its initial study .…”

Section: Introductionmentioning

confidence: 99%

Electrocardiography Screening for Hypertrophic Cardiomyopathy

Campbell

Zhou

Han

et al. 2016

Pacing Clinical Electrophis

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“…The presence and extent of LGE have been associated with LV wall thickness >30 mm and non-sustained ventricular tachycardia, both of which are independent risk factors of sudden cardiac death 15 16. As part of the screening process, ambulatory ECGs are performed to detect atrial and ventricular arrhythmia and assess voltage and non-voltage changes suggestive of HCM such as ST segment and T wave abnormalities 17 18. While the extent of LGE in paediatric patients with HCM has been reported to be similar to adults,7 19 the relationship between LGE presence and ECG findings in paediatric patients has yet to be determined.…”

Section: Introductionmentioning

confidence: 99%