Electrocardiographic poor R wave progression III. The normal variant

Zema, Michael J.; Luminais, Steven K.; Chiaramida, Salvatore A.; Goldman, Mitchell; Kligfield, Paul

doi:10.1016/s0022-0736(80)80044-6

Cited by 33 publications

(12 citation statements)

References 27 publications

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“…This criterion was fi rst adopted by Zema et al (in 1980) and has been used commonly in studies concerning PRWP (5,12,16,17) . We did not include RRWP, used in some studies (5), in our defi nition.…”

Section: Defi Nition Of Prwpmentioning

confidence: 99%

Prevalence and prognostic value of poor R-wave progression in standard resting electrocardiogram in a general adult population. The Health 2000 Survey

et al. 2010

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Section: Defi Nition Of Prwpmentioning

confidence: 99%

Prevalence and prognostic value of poor R-wave progression in standard resting electrocardiogram in a general adult population. The Health 2000 Survey

et al. 2010

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“…23 Several cardiomyopathies may also present with poor R-wave progression (eg, amiloidosis, alcoholic cardiomyopathy). 13 Recently, Anttila and coworkers 24 evaluated the prognostic impact of poor R-wave progression in a general population and showed that it predicts risk for cardiovascular mortality especially in women. In their study, poor R-wave progression was associated with higher age, hypertension, and diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…Poor R-wave progression has been correlated with myocardial cell loss and can occur in several cardiac diseases, such as alcoholic and amyloid cardiomyopathies. 13,14 Diabetes mellitus is also known to cause myocardial hypertrophy, necrosis, and apoptosis, and to increase interstitial tissue. The aim of the present study was to investigate the value of poor R-wave progression in the resting electrocardiogram as a diagnostic measure of DCMP in diabetic patients, and to evaluate its relation to the risk of developing heart failure and DCMP in these patients.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Poor R‐Wave Progression in Electrocardiograms for Diabetic Cardiomyopathy in Type 2 Diabetic Patients

Bildirici

Ural

Acar

et al. 2010

Clinical Cardiology

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Background: Diabetic cardiomyopathy (DCMP) is a common complication of diabetes and is associated with increased mortality. It has been suggested that a poor R-wave progression in a resting electrocardiogram (ECG) could be a sign of cardiomyopathy. Hypothesis: The aim of this study was primarily to analyze the relationship between poor R-wave progression and DCMP, and the effect of poor R-wave progression on cardiac functions in long-term follow-up. Methods: Seventy type 2 normotensive diabetics (33 female, 37 male; mean age, 52.9 ± 10.4 years) were included in the study. Poor R-wave progression in an ECG was defined as an R wave <3 mm in V1-3 derivations. The patients were randomized in 2 groups, which were those without (group I, n = 34) and those with poor R-wave progression (group II, n = 36). All patients underwent conventional and tissue Doppler echocardiography and were followed in an outpatient clinic setting for 4 years. Results: Demographic variables were similar between the 2 groups. In group II, left ventricular (LV) relaxation abnormality was more prevalent, the Tei index was higher, and in tissue Doppler mitral annulus Em velocities were significantly lower and Am velocities were higher than those with normal R-wave progression. At the end of the 4-year follow-up period, LV ejection fraction was decreased in group II, whereas LV mass index and Tei index were significantly increased. Conclusions: LV diastolic dysfunction is more frequently observed in diabetic patients with poor R-wave progression in ECG, which may be an early sign of LV dysfunction and DCMP in diabetics. IntroductionThe prevalence of diabetes is steadily increasing, and the number of diabetic people is expected to reach 300 million globally by 2025. 1 Cardiovascular disease is a serious of complication of diabetes and is responsible for 80% of the deaths among diabetics. 2 Although coronary artery disease is very common, heart failure is also a major cause of mortality and morbidity in patients with diabetes mellitus. 3 Up to 75% of patients with unexplained idiopathic dilated cardiomyopathy were found to be diabetic. 4 The Framingham Heart Study showed that the frequency of heart failure in diabetic men is twice that of nondiabetics, and it is 5 times higher in diabetic women compared to nondiabetic women. 1,5 Diabetic cardiomyopathy (DCMP) was first reported in 1972 by Rubler. 6 It is characterized by the development of diastolic dysfunction at the early stage followed by systolic dysfunction in the absence of coronary artery disease, hypertension, or significant valvular heart disease. 7 -9 In the Strong Heart Study, diabetes was significantly related to higher left ventricular (LV) mass and wall

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“…Yet, despite standardization of their locations since the late 1930s, precordial leads V1 through V6 are still often subject to erroneous and inconsistent placement on the chest (1,(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Such lapses in procedural adherence can lead not only to altered R-wave amplitude, but also false ECG diagnoses, most significantly ''ischemia'' (T-wave inversion, or ST-segment shifts) and ''infarction'' (Q waves or QS complexes), and additionally, ''Brugada syndrome'' (5,8,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). These misdiagnoses are far from trivial in that they can prolong evaluation time in the emergency department (ED) (and, thereby, contribute to the crowding problem); cause postponement of previously scheduled surgical procedures; lead to unnecessary non-invasive (and perhaps even invasive) diagnostic cardiac tests; prompt treatments that are potentially risky (e.g., intravenous antithrombotic or antiplatelet therapy) or expensive; and possibly raise a red flag if the patient applies for employment or life insurance (22,24).…”

Section: Introductionmentioning

confidence: 99%

Proposed Bedside Maneuver to Facilitate Accurate Anatomic Orientation for Correct Positioning of ECG Precordial Leads V1 and V2: A Pilot Study

Lehmann

Katona

2012

The Journal of Emergency Medicine

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Electrocardiographic poor R wave progression III. The normal variant

Cited by 33 publications

References 27 publications

Prevalence and prognostic value of poor R-wave progression in standard resting electrocardiogram in a general adult population. The Health 2000 Survey

Prevalence and prognostic value of poor R-wave progression in standard resting electrocardiogram in a general adult population. The Health 2000 Survey

Diagnostic Value of Poor R‐Wave Progression in Electrocardiograms for Diabetic Cardiomyopathy in Type 2 Diabetic Patients

Proposed Bedside Maneuver to Facilitate Accurate Anatomic Orientation for Correct Positioning of ECG Precordial Leads V1 and V2: A Pilot Study

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