Electrocardiographic Damage Scores and Cardiovascular Mortality

Richardson, K.; Engel, Greg; Yamazaki, Takuya

doi:10.1016/j.accreview.2005.11.035

Cited by 11 publications

(15 citation statements)

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“…4). This finding is in agreement with the results obtained in patients by Richardson et al [48] and in general population by Sundström et al [49]. Not only this, but also in our survey the excess mortality observed in subjects with echocardiographic LVH was limited to those who also had positive Sokolow-Lyon criterion; in these subjects, the risk of dying within 4 years was double than in normotrophic, while in those having nothing more than a positive echocardiogram the risk was only insignificantly increased.…”

Section: Discussionsupporting

confidence: 95%

Electrocardiographic criteria of left ventricular hypertrophy in general population

et al. 2008

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The question on whether the electrocardiographic criteria are reliable for detection of left ventricular hypertrophy (LVH) and play a role in predicting outcome is open. Answer can only proceed from population-based studies over unselected people followed up for years. In this study, 1,699 subjects from general population underwent echocardiogram and standard electrocardiogram (ECG) codified for LVH with Minnesota code and with other five methods. Other items were also recorded and used as covariables. Left ventricular mass index (LVMI) was 127.6 +/- 44.9 g m(-2) in men and 120.8 +/- 41.2 g m(-2 )in women, and correlated directly with age in both genders. Prevalence of echocardiographic LVH was 36.6% in men and 53.4% in women. LVMI correlated directly with the Sokolow-Lyon score in both genders at any age, with the Romhilt-Estes, Cornell and R(aVL) scores in all subjects but elderly men, and with the Lewis score in men and women aged < or =69 years. Sensitivity and the predictive value of electrocardiographic tests, as well as the prevalence of LVH diagnosed with electrocardiographic criteria, were always low. Specificity was high for all the tests, and in particular for the Cornell index. Only when diagnosed with echocardiogram or with the Sokolow-Lyon criterion, LVH was an independent predictor of mortality. We conclude that electrocardiographic tests cannot be used as a surrogate of echocardiogram in detecting LVH in the general population because their positive predictive value (PPV) is unacceptably low. On the contrary, they could replace echocardiography in the follow up and for prediction of outcome, when LVH has previously been correctly diagnosed with other methods

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Section: Discussionsupporting

confidence: 95%

Electrocardiographic criteria of left ventricular hypertrophy in general population

et al. 2008

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“…This further extends the results of prior reports in large cohorts of post-myocardial infarction patients 29 and more heterogenous groups of patients 19,30 showing that the QRS score was a strong independent predictor of all-cause mortality. These results suggest that QRS score carries more information than as a simple structural parameter of myocardial scar, as confirmed in the prior cited study in the SCD-HeFT in which QRS score was an independent predictor of ventricular arrhythmias.…”

Section: Myocardial Scar In Patients With Preserved Lvef and 12-lead Ecgsupporting

confidence: 77%

Screening for Cardiac Magnetic Resonance Scar Features by 12-Lead ECG, in Patients with Preserved Ejection Fraction

Mewton

Strauss

Rizzi

et al. 2015

Annals of Noninvasive Electrocardiology

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Background: Increased QRS score and wide spatial QRS-T angle are independent predictors of cardiovascular mortality in the general population. Our main objective was to assess whether a QRS score ࣙ5 and/or QRS-T angle ࣙ105°enable screening of patients for myocardial scar features.Methods: Seventy-seven patients age ࣘ70 years with QRS score ࣙ5 AND/OR spatial QRS-T angle ࣙ105°as well as left ventricular ejection fraction (LVEF) >35% were enrolled in the study. All participants underwent complete clinical examination, signal averaged ECG (SAECG), 30-minute ambulatory electrocardiogram recording for T-wave alternans (TWA), and late gadolinium enhancement cardiac magnetic resonance (LGE-CMR). Relationship between QRS score, QRS-T angle with scar presence and pattern, as well as gray zone, core, and total scar size by LGE-CMR were assessed.Results: Myocardial scar was present in 41 (53%) patients, of whom 19 (46%) exhibited a typical ischemic pattern. QRS score but not QRS-T angle was related to total scar size and gray zone size (R 2 = 0.12, P = 0.002; R 2 = 0.17; P ࣘ 0.0001, respectively). Patients with QRS scores ࣙ6 had significantly greater myocardial scar and gray zone size, increased QRS duration and QRS-T angle, a higher prevalence of late potentials presence, increased LV end-diastolic volume and decreased LVEF. There was a significant independent and positive association between TWA value and total scar (P = 0.001) and gray zone size (P = 0.01).

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“…It has also been shown that the CIIS improves the accuracy of the standard 12-lead ECG to identify patients with SC-MI. 27 The findings of our study bear particular relevance as they were derived from a cardiovascular disease-free cohort of the nationally representative sample. With vitamin D level as a surrogate marker for poor health, we may be able to identify patients who are at high risk for CVD with the use of a 12-lead ECG and scores similar to CIIS, which due to its low cost and widespread availability, is an effective screening tool.…”

Section: Discussionmentioning

confidence: 79%

Vitamin D deficiency and electrocardiographic subclinical myocardial injury: Results from National Health and Nutrition Examination Survey‐III

Ahmad

Chevli

et al. 2018

Clinical Cardiology

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Background Association of cardiovascular disease (CVD) with nontraditional risk factors such as vitamin D deficiency has been examined previously. An investigation of the association of vitamin D with subclinical myocardial injury (SC‐MI) based on an electrocardiographic score is a simple, cost‐effective and innovative way to explore this relationship. Hypothesis We hypothesize that low vitamin D levels will be associated with prevalent SC‐MI independent of traditional CVD risk factors, lifestyle factors, and socioeconomic status. Methods This analysis included 6079 participants (58.3 ± 13.1 years; 54.1% women) without CVD from the third National Health and Nutrition Examination Survey. A multivariable logistic regression model was used to examine the association between vitamin D categories (<20, 20‐29, and >30 ng/mL (reference) and cardiac injury score. Results There was an incremental increase in the prevalence of SC‐MI across vitamin D categories with the highest prevalence in <20 ng/mL, followed by 20 to 29 ng/mL and then >30 ng/mL (trend P‐value <0.0001). There was a statistically significant association between vitamin D deficiency (<20 ng/mL) and SC‐MI (odds ratio [OR] (95% confidence interval [CI]): 1.27 (1.04‐1.55), P = 0.04). This association was stronger in men than women (OR (95% CI): 1.74 (1.32‐2.30) vs 0.94 (0.70‐1.25) respectively; interaction P‐value 0.002). Conclusions Vitamin D deficiency is associated with SC‐MI, especially in men. These findings may further highlight the role of nontraditional risk factors in the development of CVD. The value of vitamin D supplementation in the prevention of myocardial ischemia and injury may warrant investigation.

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Electrocardiographic Damage Scores and Cardiovascular Mortality

Cited by 11 publications

References 0 publications

Electrocardiographic criteria of left ventricular hypertrophy in general population

Electrocardiographic criteria of left ventricular hypertrophy in general population

Screening for Cardiac Magnetic Resonance Scar Features by 12-Lead ECG, in Patients with Preserved Ejection Fraction

Vitamin D deficiency and electrocardiographic subclinical myocardial injury: Results from National Health and Nutrition Examination Survey‐III

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