Dataset Information

Validation of electrocardiographic criteria for identifying left ventricular dysfunction in patients with previous myocardial infarction.

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.

SUBMITTER: Panicker GK

PROVIDER: S-EPMC7935098 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Publications

Validation of electrocardiographic criteria for identifying left ventricular dysfunction in patients with previous myocardial infarction.

Panicker Gopi Krishna GK Narula Dhiraj D DD Albert Christine M CM Lee Daniel C DC Kothari Snehal S Goldberger Jeffrey J JJ Cook Nancy N Schaechter Andi A Kim Eunjung E Moorthy M Vinayaga MV Pester Julie J Chatterjee Neal A NA Kadish Alan H AH Karnad Dilip R DR

Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc 20201030 2

<h4>Background</h4>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.<h4>Methods</h4>ECGs and CMR from 548 patients (age 61 + 11 years, 79% male) with previous myocardial infarction (MI), from the DETERMIN ...[more]

PMID: 33124739

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Dataset Information

Validation of electrocardiographic criteria for identifying left ventricular dysfunction in patients with previous myocardial infarction.

Background

Methods

Results

Conclusions

Publications

Validation of electrocardiographic criteria for identifying left ventricular dysfunction in patients with previous myocardial infarction.

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