Dataset Information
T-wave and its association with myocardial fibrosis on cardiovascular magnetic resonance examination.
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ABSTRACT: Background
Risk stratification in non-ischemic myocardial disease poses a challenge. While cardiovascular magnetic resonance (CMR) is a comprehensive tool, the electrocardiogram (ECG) provides quick impactful clinical information. Studying the relationships between CMR and ECG can provide much-needed risk stratification. We evaluated the electrocardiographic signature of myocardial fibrosis defined as presence of late gadolinium enhancement (LGE) or extracellular volume fraction (ECV) ?29%.Methods
We evaluated 240 consecutive patients (51% female, 47.1 ± 16.6 years) referred for a clinical CMR who underwent 12-lead ECGs within 90 days. ECG parameters studied to determine association with myocardial fibrosis included heart rate, QRS amplitude/duration, T-wave amplitude, corrected QT and QT peak, and Tpeak-Tend. Abnormal T-wave was defined as low T-wave amplitude ?200 µV or a negative T wave, both in leads II and V5.Results
Of the 147 (61.3%) patients with myocardial fibrosis, 67 (28.2%) had ECV ? 29%, and 132 (54.6%) had non-ischemic LGE. An abnormal T-wave was more prevalent in patients with versus without myocardial fibrosis (66% versus 42%, p < .001). Multivariable analysis demonstrated that abnormal T-wave (OR 1.95, 95% CI 1.09-3.49, p = .03) was associated with myocardial fibrosis (ECV ? 29% or LGE) after adjustment for clinical covariates (age, gender, history of hypertension, and heart failure). Dynamic nomogram for predicting myocardial fibrosis using clinical parameters and the T-wave was developed: https://normogram.shinyapps.io/CMR_Fibrosis/.Conclusion
Low T-wave amplitude ? 200 µV or negative T-waves are independently associated with myocardial fibrosis. Prospective evaluation of T-wave amplitude may identify patients with a high probability of myocardial fibrosis and guide further indication for CMR.
SUBMITTER: Zareba KM
PROVIDER: S-EPMC7935103 | biostudies-literature | 2021 Mar
REPOSITORIES: biostudies-literature
Publications
T-wave and its association with myocardial fibrosis on cardiovascular magnetic resonance examination.
Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc 20201218 2
<h4>Background</h4>Risk stratification in non-ischemic myocardial disease poses a challenge. While cardiovascular magnetic resonance (CMR) is a comprehensive tool, the electrocardiogram (ECG) provides quick impactful clinical information. Studying the relationships between CMR and ECG can provide much-needed risk stratification. We evaluated the electrocardiographic signature of myocardial fibrosis defined as presence of late gadolinium enhancement (LGE) or extracellular volume fraction (ECV) ≥2 ...[more]