Vectorcardiography as a prognostic tool in hypertrophic cardiomyopathy.
Electrocardiogram
Hypertrophic cardiomyopathy
Risk stratification
Sudden cardiac death
Vectorcardiography
Journal
Journal of electrocardiology
ISSN: 1532-8430
Titre abrégé: J Electrocardiol
Pays: United States
ID NLM: 0153605
Informations de publication
Date de publication:
Historique:
received:
03
05
2021
revised:
25
07
2021
accepted:
03
08
2021
pubmed:
16
8
2021
medline:
25
2
2023
entrez:
15
8
2021
Statut:
ppublish
Résumé
Vectorcardiography (VCG) has demonstrated diagnostic value in the assessment of hypertrophic cardiomyopathy (HCM), however, determining its prognostic value over time has not yet been investigated. This study sought to assess the correlation of VCG parameters with the progression of HCM. A retrospective chart review of 119 pediatric patients with diagnosis of HCM at the University of Minnesota. Eighty-three cases were excluded because of age, presence of congenital heart disease, not meeting criteria for HCM or negative phenotype. Sample was divided into 2 groups based on the presence or not of cardiac events (ventricular tachycardia, cardiac arrest, ventricular assist device, heart transplant). Derived vectorcardiography from standard 12‑lead ECG was obtained for the first ECG and last available or prior to sentinel event. Of the 36 cases that met inclusion criteria, 9 (25%) developed a sentinel event. The median age for the event group was 10.1 ± 7.5 years and for the non-event group was 8.7 ± 6.35 years. There was no significant difference in age or sex between the groups. The T wave vector magnitude value was significantly smaller in the event group than in the non-event group (0.302 ± 0.146 mV Vs. 0.561 ± 0.305 mV, p 0.002), with a hazard ratio of 0.651 (95% CI 0.463 to 0.915). No other parameter showed significant difference between the two groups. The T wave vector magnitude may predict sentinel events in HCM. Prospective studies are necessary to evaluate the utility of the evolution of VCG parameters.
Sections du résumé
BACKGROUND
Vectorcardiography (VCG) has demonstrated diagnostic value in the assessment of hypertrophic cardiomyopathy (HCM), however, determining its prognostic value over time has not yet been investigated. This study sought to assess the correlation of VCG parameters with the progression of HCM.
METHODS
A retrospective chart review of 119 pediatric patients with diagnosis of HCM at the University of Minnesota. Eighty-three cases were excluded because of age, presence of congenital heart disease, not meeting criteria for HCM or negative phenotype. Sample was divided into 2 groups based on the presence or not of cardiac events (ventricular tachycardia, cardiac arrest, ventricular assist device, heart transplant). Derived vectorcardiography from standard 12‑lead ECG was obtained for the first ECG and last available or prior to sentinel event.
RESULTS
Of the 36 cases that met inclusion criteria, 9 (25%) developed a sentinel event. The median age for the event group was 10.1 ± 7.5 years and for the non-event group was 8.7 ± 6.35 years. There was no significant difference in age or sex between the groups. The T wave vector magnitude value was significantly smaller in the event group than in the non-event group (0.302 ± 0.146 mV Vs. 0.561 ± 0.305 mV, p 0.002), with a hazard ratio of 0.651 (95% CI 0.463 to 0.915). No other parameter showed significant difference between the two groups.
CONCLUSIONS
The T wave vector magnitude may predict sentinel events in HCM. Prospective studies are necessary to evaluate the utility of the evolution of VCG parameters.
Identifiants
pubmed: 34392139
pii: S0022-0736(21)00169-2
doi: 10.1016/j.jelectrocard.2021.08.004
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
80-84Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors do not have any relationship with industry and other relevant entities, financial or otherwise, that might pose a conflict of interest in connection with the content of this article.