1
|
Varoni LPC, Samesima N, Facin M, Filho HGP, Madaloso BA, Junior WM, Pastore CA. Electrovectorcardiographic study of left ventricular aneurysm in ischemic heart disease. Front Cardiovasc Med 2023; 10:1275194. [PMID: 38155984 PMCID: PMC10754535 DOI: 10.3389/fcvm.2023.1275194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/27/2023] [Indexed: 12/30/2023] Open
Abstract
The aim was to characterize the electrovectorcardiographic pattern of ventricular aneurysms in ischemic cardiopathy by analyzing the cardiac ventricular repolarization. The medical records of 2,670 individuals were analyzed in this cross-sectional study. A test phase included 33 patients who underwent transthoracic echocardiogram with ultrasonic enhancing agent, electrocardiogram, and vectorcardiogram (aneurysm group - n = 22, and akinesia group - n = 11). In the validation phase, cardiac magnetic resonance imaging established the left ventricle segmental contractility in 16 patients who underwent electrocardiographic and vectorcardiographic tests (aneurysm group, n = 8, and akinesia group, n = 8). The variables studied were the presence of the T-wave plus-minus pattern and the T-wave loop anterior-posterior pattern in V2-V4. The diagnostic indices used were sensitivity, specificity, and predictive values, with their respective 95% confidence intervals. During the test and validation phases, the analysis of the presence of the T-wave plus-minus pattern identified the aneurysm group with a sensitivity of 91% vs. 87% and specificity of 91% vs. 87% (p < 0.0001 vs. p = 0.01), respectively. Meanwhile, the T-wave loop anterior-posterior pattern evidenced sensitivity of 95% vs. 77% and specificity of 91% vs. 87% (p < 0.0001 vs. p = 0.04), respectively. The electrovectorcardiographic parameters showed high accuracy for recognizing left ventricular aneurysms in ischemic heart disease.
Collapse
Affiliation(s)
- Leonardo Paschoal Camacho Varoni
- Clinical Unit of Electrocardiography, Instituto do Coracao (InCor), Hospital das Clínicas FMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Nelson Samesima
- Clinical Unit of Electrocardiography, Instituto do Coracao (InCor), Hospital das Clínicas FMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Mirella Facin
- Clinical Unit of Electrocardiography, Instituto do Coracao (InCor), Hospital das Clínicas FMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Horácio Gomes Pereira Filho
- Clinical Unit of Electrocardiography, Instituto do Coracao (InCor), Hospital das Clínicas FMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Bruna Affonso Madaloso
- Clinical Unit of Electrocardiography, Instituto do Coracao (InCor), Hospital das Clínicas FMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Wilson Mathias Junior
- Echocardiography Unit, Instituto do Coracao (InCor), Hospital das Clínicas FMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Carlos Alberto Pastore
- Clinical Unit of Electrocardiography, Instituto do Coracao (InCor), Hospital das Clínicas FMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
2
|
Nikus K, Manzzardo J, Pérez-Riera AR. This Could Mean a True Tetrafascicular Intraventricular Block. JAMA Intern Med 2023; 183:392-393. [PMID: 36848134 DOI: 10.1001/jamainternmed.2022.6938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Affiliation(s)
- Kjell Nikus
- Heart Center, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Juan Manzzardo
- Servicio de Cardiología, Hospital Ítalo Alfredo Perrupato, San Martín y Area Sanitaria Junín, Mendoza, Argentina
| | - Andrés Ricardo Pérez-Riera
- Laboratório de Delineamento de Pesquisas e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, Brazil.,Clínica Médica e suas Especialidades, Universidade Uninove, Mauá, São Paulo, Brazil
| |
Collapse
|
3
|
Andalaft RB. The Electrocardiogram in the Pediatric Population in the 21st Century. How to Keep Evolving after 135 Years of the Method Discovery History. Arq Bras Cardiol 2022; 119:791-792. [PMID: 36453771 PMCID: PMC9750202 DOI: 10.36660/abc.20220715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Rogerio Braga Andalaft
- Instituto Dante Pazzanese de Cardiologia – EletrofisiologiaSão PauloSPBrasilInstituto Dante Pazzanese de Cardiologia – Eletrofisiologia, São Paulo, SP – Brasil
- Hospital Israelita Albert EinsteinSão PauloSPBrasilHospital Israelita Albert Einstein, São Paulo, SP – Brasil
| |
Collapse
|