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Roshchevskaya IM, Suslonova OV, Smirnova SL, Ionova EO, Vititnova MB, Tsorin IB, Kryzhanovskii SA. Correlation of the Left Ventricular Systolic Dysfunction and Ventricular Depolarization in a Post-Infarction Model of Chronic Heart Failure. Bull Exp Biol Med 2024; 176:428-432. [PMID: 38488960 DOI: 10.1007/s10517-024-06040-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Indexed: 03/17/2024]
Abstract
The body surface potential mapping of the heart during the period of ventricular depolarization and the inotropic function of the ventricles were studied in rats under conditions of a translational model of post-infarction chronic heart failure developed by us. We revealed a statistically significant (p<0.001) correlation between the left-ventricular ejection fraction and the values of the maximum positive and negative extrema of the cardioelectric field on the body surface of rats with post-infarction chronic heart failure caused by anterior transmural myocardial infarction. The calculated linear regression equations have high predictive efficiency, which makes it possible to use the amplitude characteristics of the heart cardioelectric field as a marker of the development of chronic heart failure.
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Affiliation(s)
| | - O V Suslonova
- Department of Comparative Cardiology, Federal Research Center Komi Scientific Center, Ural Branch of the Russian Academy of Sciences, Syktyvkar, Komi Republic, Russia
| | - S L Smirnova
- Department of Comparative Cardiology, Federal Research Center Komi Scientific Center, Ural Branch of the Russian Academy of Sciences, Syktyvkar, Komi Republic, Russia
| | - E O Ionova
- V. V. Zakusov Research Institute of Pharmacology, Moscow, Russia
| | - M B Vititnova
- V. V. Zakusov Research Institute of Pharmacology, Moscow, Russia
| | - I B Tsorin
- V. V. Zakusov Research Institute of Pharmacology, Moscow, Russia
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2
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Okamoto H, Miyatake H, Kodama M, Matsubayashi J, Matsutani N, Fujino K, Tsujita Y, Shiomi N, Nakagawa Y. Discriminative Ability of Dynamic Chest Radiography to Identify Left Ventricular Dysfunction. Circ J 2023; 88:159-167. [PMID: 38030239 DOI: 10.1253/circj.cj-23-0429] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
BACKGROUND Dynamic chest radiography (DCR) produces sequential radiographs within a short examination time. It is also inexpensive and only uses a low dose of radiation. Because of the lack of reports of evaluating cardiac function using DCR in humans, we investigated its discriminative ability for left ventricular (LV) dysfunction in a study cohort. METHODS AND RESULTS We analyzed the DCR pixel values of 4 circular regions of interest (ROIs) in the hearts of 61 patients with cardiovascular disease and 10 healthy volunteers. We evaluated the relationship between changes in pixel value in the heart and the LV ejection fraction (LVEF) by echocardiography. We constructed receiver operating characteristic (ROC) curves to evaluate whether the percent change in pixel value (%∆pixel value) could be used to identify patients with reduced LVEF. A total of 21 patients had reduced LVEF (LVEF <50%), and 40 had preserved LVEF (LVEF ≥50%). The correlation between LVEF and %∆pixel value in each ROI was significant, and the area under the ROC curve of the %∆pixel values for identifying patients with reduced LVEF was satisfactory (0.808-0.827) in 3 ROIs where the entire circular area was within the cardiac shadow. CONCLUSIONS LV dysfunction can be detected by changes in the pixel value on DCR.
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Affiliation(s)
- Hiroki Okamoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Shiga University of Medical Science
| | - Hidemitsu Miyatake
- Department of Critical and Intensive Care Medicine, Shiga University of Medical Science
| | - Misato Kodama
- Division of Cardiovascular Medicine, Department of Internal Medicine, Shiga University of Medical Science
| | - Jun Matsubayashi
- Center for Clinical Research and Advanced Medicine, Shiga University of Medical Science
| | | | - Kazunori Fujino
- Department of Critical and Intensive Care Medicine, Shiga University of Medical Science
| | - Yasuyuki Tsujita
- Department of Critical and Intensive Care Medicine, Shiga University of Medical Science
| | - Naoto Shiomi
- Department of Critical and Intensive Care Medicine, Shiga University of Medical Science
| | - Yoshihisa Nakagawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Shiga University of Medical Science
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3
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Kadado AJ, Pervaiz A, Gobeil K, Shikari S, Elder P, Battisha A, Walia R, Hiser W, Lagu T, Pack QR. Electrocardiogram changes as predictors for new imaging findings in repeat transthoracic echocardiography. Future Cardiol 2023; 19:487-495. [PMID: 37721317 PMCID: PMC10599417 DOI: 10.2217/fca-2023-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
Aim: To determine if electrocardiogram (EKG) findings may be a useful tool to predict changes in repeat transthoracic echocardiogram (TTE). Methods: We evaluated patients who underwent TTE during hospitalization and their EKGs, and whether findings differed between studies. Results: Of 229 hospitalized patients who underwent repeat TTE, 183 (80%) were abnormal. Each minor and major EKG abnormality resulted in a 1.8 (1.2 to 2.6; p = 0.002) and 2.1 (1.3 to 3.3; p < 0.001) increased odds of abnormal imaging on TTE, respectively. The negative likelihood ratio for an unchanged EKG to predict an unchanged TTE was 0.68 (95% CI = 0.62 to 0.73). Conclusion: Among hospitalized patients with prior imaging results, an unchanged EKG predicts an unchanged TTE.
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Affiliation(s)
- Anis John Kadado
- Division of Cardiovascular Medicine, University of Massachusetts Medical School, Baystate Medical Center, Springfield, MA 01199, USA
| | - Abdullah Pervaiz
- Division of Cardiovascular Medicine, University of Massachusetts Medical School, Baystate Medical Center, Springfield, MA 01199, USA
| | - Kyle Gobeil
- Division of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Saima Shikari
- Division of Cardiovascular Medicine, University of Kentucky Medical Center, Lexington, KY 40536, USA
| | - Petal Elder
- Department of Medicine, University of Massachusetts Medical School, Baystate Medical Center, Springfield, MA 01199, USA
| | - Ayman Battisha
- Department of Medicine, University of Massachusetts Medical School, Baystate Medical Center, Springfield, MA 01199, USA
| | - Ritika Walia
- Department of Medicine, University of Massachusetts Medical School, Baystate Medical Center, Springfield, MA 01199, USA
| | - William Hiser
- Division of Cardiovascular Medicine, University of Massachusetts Medical School, Baystate Medical Center, Springfield, MA 01199, USA
| | - Tara Lagu
- Division of Hospital Medicine, Northwestern Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Quinn R Pack
- Division of Cardiovascular Medicine, University of Massachusetts Medical School, Baystate Medical Center, Springfield, MA 01199, USA
- Institute for Healthcare Delivery & Population Science at University of Massachusetts Medical School – Baystate, Springfield, MA 01199, USA
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Yildirim A, Karaca IO, Yilmaz FK, Gunes HM, Cakal B. Fragmented QRS on surface electrocardiography as a predictor of cardiac mortality in patients with SARS-CoV-2 infection. J Electrocardiol 2021; 66:108-112. [PMID: 33906057 PMCID: PMC7967400 DOI: 10.1016/j.jelectrocard.2021.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/14/2021] [Accepted: 03/06/2021] [Indexed: 12/25/2022]
Abstract
Aims Although severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is mainly a respiratory system disease, recent studies reported that cardiac injury is associated with poor outcomes in this population. There are few studies which assessed standard electrocardiogram (ECG) as a prognostic tool during the course of SARS-CoV-2 infection. The aim of this study is to identify the relationship between of ECG parameters and prognosis of patients infected with SARS-CoV-2. Method and results A total of 114 consecutive patients with a confirmed diagnosis of SARS-CoV-2 infection between March 2020 and May 2020 were included in the study. Standard 12‑lead surface ECG was reviewed for presence of fragmented QRS (fQRS), abnormal Q wave, T wave inversion, and duration of QRS. fQRS was observed in 36.8% (n = 42) of the patients who had SARS-CoV-2. Patient groups with and without fQRS did not differ in terms of age, gender, the presence of comorbid diseases and medical treatment. Hospitalization duration, intensive care unit(ICU) requirement, all-cause mortality, and cardiac mortality were found to be higher in patients with fQRS (all p values <0.05). There was a positive correlation between QRS duration and duration of hospital stay (p < 0.001, r = 0.421). QRS duration was also found to be associated with intensive care need, all-cause mortality, and cardiac mortality. Conclusion Our data shows that QRS duration and the presence of fQRS on standard ECG can help to identify patients with worse clinical outcome admitted for SARS-CoV-2 infection.
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Affiliation(s)
- Arzu Yildirim
- Medipol University Faculty of Medicine, Cardiology Department, İstanbul, Turkey.
| | - I Oguz Karaca
- Medipol University Faculty of Medicine, Cardiology Department, İstanbul, Turkey
| | | | - H Murat Gunes
- Medipol University Faculty of Medicine, Cardiology Department, İstanbul, Turkey
| | - Beytullah Cakal
- Medipol University Faculty of Medicine, Cardiology Department, İstanbul, Turkey
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Panicker GK, Narula DD, Albert CM, Lee DC, Kothari S, Goldberger JJ, Cook N, Schaechter A, Kim E, Moorthy MV, Pester J, Chatterjee NA, Kadish AH, Karnad DR. Validation of electrocardiographic criteria for identifying left ventricular dysfunction in patients with previous myocardial infarction. Ann Noninvasive Electrocardiol 2020; 26:e12812. [PMID: 33124739 PMCID: PMC7935098 DOI: 10.1111/anec.12812] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 09/03/2020] [Indexed: 12/03/2022] Open
Abstract
Background Eleven criteria correlating electrocardiogram (ECG) findings with reduced left ventricular ejection fraction (LVEF) have been previously published. These have not been compared head‐to‐head in a single study. We studied their value as a screening test to identify patients with reduced LVEF estimated by cardiac magnetic resonance (CMR) imaging. Methods ECGs and CMR from 548 patients (age 61 + 11 years, 79% male) with previous myocardial infarction (MI), from the DETERMINE and PRE‐DETERMINE studies, were analyzed. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each criterion for identifying patients with LVEF ≤ 30% and ≤ 40% were studied. A useful screening test should have high sensitivity and NPV. Results Mean LVEF was 40% (SD = 11%); 264 patients (48.2%) had LVEF ≤ 40%, and 96 patients (17.5%) had LVEF ≤ 30%. Six of 11 criteria were associated with a significant lower LVEF, but had poor sensitivity to identify LVEF ≤ 30% (range 2.1%–55.2%) or LVEF ≤ 40% (1.1%–51.1%); NPVs were good for LVEF ≤ 30% (range 82.8%–85.9%) but not for LVEF ≤ 40% (range 52.1%–60.6%). Goldberger's third criterion (RV4/SV4 < 1) and combinations of maximal QRS duration > 124 ms + either Goldberger's third criterion or Goldberger's first criterion (SV1 or SV2 + RV5 or RV6 ≥ 3.5 mV) had high specificity (95.4%–100%) for LVEF ≤ 40%, although seen in only 48 (8.8%) patients; predictive values were similar on subgroup analysis. Conclusions None of the ECG criteria qualified as a good screening test. Three criteria had high specificity for LVEF ≤ 40%, although seen in < 9% of patients. Whether other ECG criteria can better identify LV dysfunction remains to be determined.
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Affiliation(s)
| | | | - Christine M Albert
- Brigham and Women's Hospital, Boston, MA, USA.,Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Daniel C Lee
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | - Nancy Cook
- Brigham and Women's Hospital, Boston, MA, USA
| | - Andi Schaechter
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Eunjung Kim
- Brigham and Women's Hospital, Boston, MA, USA
| | | | | | | | - Alan H Kadish
- Touro College and University System, New York, NY, USA
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