Usefulness of Electrocardiographic Patterns at Presentation to Predict Long-term Risk of Cardiac Death in Patients With Hypertrophic Cardiomyopathy
The objective of this study was to investigate the prognostic significance of 12-lead electrocardiogram (ECG) patterns in a large multicenter cohort of patients with hypertrophic cardiomyopathy; 1,004 consecutive patients with hypertrophic cardiomyopathy and a recorded standard ECG (64% men, mean ag...
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| Veröffentlicht in: | The American journal of cardiology 2016-08, Vol.118 (3), p.432-439 |
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| creator | Biagini, Elena Pazzi, Chiara Olivotto, Iacopo Musumeci, Beatrice Limongelli, Giuseppe Boriani, Giuseppe Pacileo, Giuseppe Mastromarino, Vittoria Bacchi Reggiani, Maria Letizia Lorenzini, Massimiliano Lai, Francesco Berardini, Alessandra Mingardi, Francesca Rosmini, Stefania Resciniti, Elvira Borghi, Claudia Autore, Camillo Cecchi, Franco Rapezzi, Claudio |
| description | The objective of this study was to investigate the prognostic significance of 12-lead electrocardiogram (ECG) patterns in a large multicenter cohort of patients with hypertrophic cardiomyopathy; 1,004 consecutive patients with hypertrophic cardiomyopathy and a recorded standard ECG (64% men, mean age 50 ± 16 years) were evaluated at 4 Italian centers. The study end points were sudden cardiac death (SCD) or surrogates, including appropriate implanted cardiac defibrillator discharge and resuscitated cardiac arrest and major cardiovascular events (including SCD or surrogates and death due to heart failure, cardioembolic stroke, or heart transplantation). Prevalence of baseline electrocardiographic characteristics was: normal ECG 4%, ST-segment depression 56%, pseudonecrosis waves 33%, “pseudo–ST-segment elevation myocardial infarction (STEMI)” pattern 17%, QRS duration ≥120 ms 17%, giant inverted T waves 6%, and low QRS voltages 3%. During a mean follow-up of 7.4 ± 6.8 years, 77 patients experienced SCD or surrogates and 154 patients experienced major cardiovascular events. Independent predictors of SCD or surrogates were unexplained syncope (hazard ratio [HR] 2.5, 95% confidence interval [CI] 1.4 to 4.5, p = 0.003), left ventricular ejection fraction |
| doi_str_mv | 10.1016/j.amjcard.2016.05.023 |
| format | Article |
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The study end points were sudden cardiac death (SCD) or surrogates, including appropriate implanted cardiac defibrillator discharge and resuscitated cardiac arrest and major cardiovascular events (including SCD or surrogates and death due to heart failure, cardioembolic stroke, or heart transplantation). Prevalence of baseline electrocardiographic characteristics was: normal ECG 4%, ST-segment depression 56%, pseudonecrosis waves 33%, “pseudo–ST-segment elevation myocardial infarction (STEMI)” pattern 17%, QRS duration ≥120 ms 17%, giant inverted T waves 6%, and low QRS voltages 3%. During a mean follow-up of 7.4 ± 6.8 years, 77 patients experienced SCD or surrogates and 154 patients experienced major cardiovascular events. Independent predictors of SCD or surrogates were unexplained syncope (hazard ratio [HR] 2.5, 95% confidence interval [CI] 1.4 to 4.5, p = 0.003), left ventricular ejection fraction <50% (HR 3.5, 95% CI 1.9 to 6.7, p = 0.0001), nonsustained ventricular tachycardia (HR 1.7, 95% CI 1.1 to 2.6, p = 0.027), pseudo-STEMI pattern (HR 2.3, 95% CI 1.4 to 3.8, p = 0.001), QRS duration ≥120 ms (HR 1.8, 95% CI 1.1 to 3.0, p = 0.033), and low QRS voltages (HR 2.3, 95% CI 1.01 to 5.1, p = 0.048). Independent predictors of major cardiovascular events were age (HR 1.02, 95% CI 1.01 to 1.03, p = 0.0001), LV ejection fraction <50% (HR 3.73, 95% CI 2.39 to 5.83, p = 0.0001), pseudo-STEMI pattern (HR 1.66, 95% CI 1.13 to 2.45, p = 0.010), QRS duration ≥120 ms (HR 1.69, 95% CI 1.16 to 2.47, p = 0.007), and prolonged QTc interval (HR 1.68, 95% CI 1.21 to 2.34, p = 0.002). In conclusion, a detailed qualitative and quantitative electrocardiographic analyses provide independent predictors of prognosis that could be integrated with the available score systems to improve the power of the current model.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2016.05.023</identifier><identifier>PMID: 27289293</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Age Factors ; Aged ; Cardiac arrhythmia ; Cardiomyopathy ; Cardiomyopathy, Hypertrophic - mortality ; Cardiomyopathy, Hypertrophic - physiopathology ; Colleges & universities ; Death, Sudden, Cardiac - epidemiology ; Electrocardiography ; Female ; Gangrene ; Heart attacks ; Heart Failure - mortality ; Heart Transplantation ; Humans ; Italy - epidemiology ; Male ; Medical prognosis ; Middle Aged ; Multivariate analysis ; Proportional Hazards Models ; Retrospective Studies ; Stroke - mortality ; Stroke Volume ; Survival analysis ; Syncope - epidemiology ; Tachycardia, Ventricular - epidemiology ; Tachycardia, Ventricular - physiopathology ; Young Adult</subject><ispartof>The American journal of cardiology, 2016-08, Vol.118 (3), p.432-439</ispartof><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Aug 1, 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c473t-a51871339fea36e795bf07a46a3a1a7dbe8940a15229bc7ca0f1b140407f7df33</citedby><cites>FETCH-LOGICAL-c473t-a51871339fea36e795bf07a46a3a1a7dbe8940a15229bc7ca0f1b140407f7df33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1805650457?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27289293$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Biagini, Elena</creatorcontrib><creatorcontrib>Pazzi, Chiara</creatorcontrib><creatorcontrib>Olivotto, Iacopo</creatorcontrib><creatorcontrib>Musumeci, Beatrice</creatorcontrib><creatorcontrib>Limongelli, Giuseppe</creatorcontrib><creatorcontrib>Boriani, Giuseppe</creatorcontrib><creatorcontrib>Pacileo, Giuseppe</creatorcontrib><creatorcontrib>Mastromarino, Vittoria</creatorcontrib><creatorcontrib>Bacchi Reggiani, Maria Letizia</creatorcontrib><creatorcontrib>Lorenzini, Massimiliano</creatorcontrib><creatorcontrib>Lai, Francesco</creatorcontrib><creatorcontrib>Berardini, Alessandra</creatorcontrib><creatorcontrib>Mingardi, Francesca</creatorcontrib><creatorcontrib>Rosmini, Stefania</creatorcontrib><creatorcontrib>Resciniti, Elvira</creatorcontrib><creatorcontrib>Borghi, Claudia</creatorcontrib><creatorcontrib>Autore, Camillo</creatorcontrib><creatorcontrib>Cecchi, Franco</creatorcontrib><creatorcontrib>Rapezzi, Claudio</creatorcontrib><title>Usefulness of Electrocardiographic Patterns at Presentation to Predict Long-term Risk of Cardiac Death in Patients With Hypertrophic Cardiomyopathy</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>The objective of this study was to investigate the prognostic significance of 12-lead electrocardiogram (ECG) patterns in a large multicenter cohort of patients with hypertrophic cardiomyopathy; 1,004 consecutive patients with hypertrophic cardiomyopathy and a recorded standard ECG (64% men, mean age 50 ± 16 years) were evaluated at 4 Italian centers. The study end points were sudden cardiac death (SCD) or surrogates, including appropriate implanted cardiac defibrillator discharge and resuscitated cardiac arrest and major cardiovascular events (including SCD or surrogates and death due to heart failure, cardioembolic stroke, or heart transplantation). Prevalence of baseline electrocardiographic characteristics was: normal ECG 4%, ST-segment depression 56%, pseudonecrosis waves 33%, “pseudo–ST-segment elevation myocardial infarction (STEMI)” pattern 17%, QRS duration ≥120 ms 17%, giant inverted T waves 6%, and low QRS voltages 3%. During a mean follow-up of 7.4 ± 6.8 years, 77 patients experienced SCD or surrogates and 154 patients experienced major cardiovascular events. Independent predictors of SCD or surrogates were unexplained syncope (hazard ratio [HR] 2.5, 95% confidence interval [CI] 1.4 to 4.5, p = 0.003), left ventricular ejection fraction <50% (HR 3.5, 95% CI 1.9 to 6.7, p = 0.0001), nonsustained ventricular tachycardia (HR 1.7, 95% CI 1.1 to 2.6, p = 0.027), pseudo-STEMI pattern (HR 2.3, 95% CI 1.4 to 3.8, p = 0.001), QRS duration ≥120 ms (HR 1.8, 95% CI 1.1 to 3.0, p = 0.033), and low QRS voltages (HR 2.3, 95% CI 1.01 to 5.1, p = 0.048). Independent predictors of major cardiovascular events were age (HR 1.02, 95% CI 1.01 to 1.03, p = 0.0001), LV ejection fraction <50% (HR 3.73, 95% CI 2.39 to 5.83, p = 0.0001), pseudo-STEMI pattern (HR 1.66, 95% CI 1.13 to 2.45, p = 0.010), QRS duration ≥120 ms (HR 1.69, 95% CI 1.16 to 2.47, p = 0.007), and prolonged QTc interval (HR 1.68, 95% CI 1.21 to 2.34, p = 0.002). In conclusion, a detailed qualitative and quantitative electrocardiographic analyses provide independent predictors of prognosis that could be integrated with the available score systems to improve the power of the current model.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Cardiac arrhythmia</subject><subject>Cardiomyopathy</subject><subject>Cardiomyopathy, Hypertrophic - mortality</subject><subject>Cardiomyopathy, Hypertrophic - physiopathology</subject><subject>Colleges & universities</subject><subject>Death, Sudden, Cardiac - epidemiology</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Gangrene</subject><subject>Heart attacks</subject><subject>Heart Failure - mortality</subject><subject>Heart Transplantation</subject><subject>Humans</subject><subject>Italy - epidemiology</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Stroke - 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mortality</topic><topic>Cardiomyopathy, Hypertrophic - physiopathology</topic><topic>Colleges & universities</topic><topic>Death, Sudden, Cardiac - epidemiology</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Gangrene</topic><topic>Heart attacks</topic><topic>Heart Failure - mortality</topic><topic>Heart Transplantation</topic><topic>Humans</topic><topic>Italy - epidemiology</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Stroke - mortality</topic><topic>Stroke Volume</topic><topic>Survival analysis</topic><topic>Syncope - epidemiology</topic><topic>Tachycardia, Ventricular - epidemiology</topic><topic>Tachycardia, Ventricular - physiopathology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Biagini, Elena</creatorcontrib><creatorcontrib>Pazzi, Chiara</creatorcontrib><creatorcontrib>Olivotto, Iacopo</creatorcontrib><creatorcontrib>Musumeci, Beatrice</creatorcontrib><creatorcontrib>Limongelli, Giuseppe</creatorcontrib><creatorcontrib>Boriani, Giuseppe</creatorcontrib><creatorcontrib>Pacileo, Giuseppe</creatorcontrib><creatorcontrib>Mastromarino, Vittoria</creatorcontrib><creatorcontrib>Bacchi Reggiani, Maria Letizia</creatorcontrib><creatorcontrib>Lorenzini, Massimiliano</creatorcontrib><creatorcontrib>Lai, Francesco</creatorcontrib><creatorcontrib>Berardini, Alessandra</creatorcontrib><creatorcontrib>Mingardi, Francesca</creatorcontrib><creatorcontrib>Rosmini, Stefania</creatorcontrib><creatorcontrib>Resciniti, Elvira</creatorcontrib><creatorcontrib>Borghi, Claudia</creatorcontrib><creatorcontrib>Autore, Camillo</creatorcontrib><creatorcontrib>Cecchi, Franco</creatorcontrib><creatorcontrib>Rapezzi, Claudio</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biochemistry Abstracts 1</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Biotechnology Research Abstracts</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Biagini, Elena</au><au>Pazzi, Chiara</au><au>Olivotto, Iacopo</au><au>Musumeci, Beatrice</au><au>Limongelli, Giuseppe</au><au>Boriani, Giuseppe</au><au>Pacileo, Giuseppe</au><au>Mastromarino, Vittoria</au><au>Bacchi Reggiani, Maria Letizia</au><au>Lorenzini, Massimiliano</au><au>Lai, Francesco</au><au>Berardini, Alessandra</au><au>Mingardi, Francesca</au><au>Rosmini, Stefania</au><au>Resciniti, Elvira</au><au>Borghi, Claudia</au><au>Autore, Camillo</au><au>Cecchi, Franco</au><au>Rapezzi, Claudio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Usefulness of Electrocardiographic Patterns at Presentation to Predict Long-term Risk of Cardiac Death in Patients With Hypertrophic Cardiomyopathy</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2016-08-01</date><risdate>2016</risdate><volume>118</volume><issue>3</issue><spage>432</spage><epage>439</epage><pages>432-439</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>The objective of this study was to investigate the prognostic significance of 12-lead electrocardiogram (ECG) patterns in a large multicenter cohort of patients with hypertrophic cardiomyopathy; 1,004 consecutive patients with hypertrophic cardiomyopathy and a recorded standard ECG (64% men, mean age 50 ± 16 years) were evaluated at 4 Italian centers. The study end points were sudden cardiac death (SCD) or surrogates, including appropriate implanted cardiac defibrillator discharge and resuscitated cardiac arrest and major cardiovascular events (including SCD or surrogates and death due to heart failure, cardioembolic stroke, or heart transplantation). Prevalence of baseline electrocardiographic characteristics was: normal ECG 4%, ST-segment depression 56%, pseudonecrosis waves 33%, “pseudo–ST-segment elevation myocardial infarction (STEMI)” pattern 17%, QRS duration ≥120 ms 17%, giant inverted T waves 6%, and low QRS voltages 3%. During a mean follow-up of 7.4 ± 6.8 years, 77 patients experienced SCD or surrogates and 154 patients experienced major cardiovascular events. Independent predictors of SCD or surrogates were unexplained syncope (hazard ratio [HR] 2.5, 95% confidence interval [CI] 1.4 to 4.5, p = 0.003), left ventricular ejection fraction <50% (HR 3.5, 95% CI 1.9 to 6.7, p = 0.0001), nonsustained ventricular tachycardia (HR 1.7, 95% CI 1.1 to 2.6, p = 0.027), pseudo-STEMI pattern (HR 2.3, 95% CI 1.4 to 3.8, p = 0.001), QRS duration ≥120 ms (HR 1.8, 95% CI 1.1 to 3.0, p = 0.033), and low QRS voltages (HR 2.3, 95% CI 1.01 to 5.1, p = 0.048). Independent predictors of major cardiovascular events were age (HR 1.02, 95% CI 1.01 to 1.03, p = 0.0001), LV ejection fraction <50% (HR 3.73, 95% CI 2.39 to 5.83, p = 0.0001), pseudo-STEMI pattern (HR 1.66, 95% CI 1.13 to 2.45, p = 0.010), QRS duration ≥120 ms (HR 1.69, 95% CI 1.16 to 2.47, p = 0.007), and prolonged QTc interval (HR 1.68, 95% CI 1.21 to 2.34, p = 0.002). In conclusion, a detailed qualitative and quantitative electrocardiographic analyses provide independent predictors of prognosis that could be integrated with the available score systems to improve the power of the current model.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27289293</pmid><doi>10.1016/j.amjcard.2016.05.023</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The American journal of cardiology, 2016-08, Vol.118 (3), p.432-439 |
| issn | 0002-9149 1879-1913 |
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| source | MEDLINE; Access via ScienceDirect (Elsevier); ProQuest Central UK/Ireland |
| subjects | Adolescent Adult Age Factors Aged Cardiac arrhythmia Cardiomyopathy Cardiomyopathy, Hypertrophic - mortality Cardiomyopathy, Hypertrophic - physiopathology Colleges & universities Death, Sudden, Cardiac - epidemiology Electrocardiography Female Gangrene Heart attacks Heart Failure - mortality Heart Transplantation Humans Italy - epidemiology Male Medical prognosis Middle Aged Multivariate analysis Proportional Hazards Models Retrospective Studies Stroke - mortality Stroke Volume Survival analysis Syncope - epidemiology Tachycardia, Ventricular - epidemiology Tachycardia, Ventricular - physiopathology Young Adult |
| title | Usefulness of Electrocardiographic Patterns at Presentation to Predict Long-term Risk of Cardiac Death in Patients With Hypertrophic Cardiomyopathy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-22T06%3A48%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Usefulness%20of%20Electrocardiographic%20Patterns%20at%20Presentation%20to%20Predict%20Long-term%20Risk%20of%20Cardiac%20Death%20in%20Patients%20With%20Hypertrophic%20Cardiomyopathy&rft.jtitle=The%20American%20journal%20of%20cardiology&rft.au=Biagini,%20Elena&rft.date=2016-08-01&rft.volume=118&rft.issue=3&rft.spage=432&rft.epage=439&rft.pages=432-439&rft.issn=0002-9149&rft.eissn=1879-1913&rft.coden=AJCDAG&rft_id=info:doi/10.1016/j.amjcard.2016.05.023&rft_dat=%3Cproquest_cross%3E4122661961%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1805650457&rft_id=info:pmid/27289293&rft_els_id=S0002914916308773&rfr_iscdi=true |