Electrocardiographic predictors of right ventricular volume measured by magnetic resonance imaging late after total repair of tetralogy of fallot
Background: Right ventricular dysfunction occurs in many patients with significant pulmonary valve regurgitation late after initial total repair of tetralogy of Fallot. Methods to predict which of these patients are at increased risk of late morbidity and mortality are not yet known. Hypothesis: Thi...
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| Veröffentlicht in: | Clinical cardiology (Mahwah, N.J.) N.J.), 1999-11, Vol.22 (11), p.740-746 |
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| creator | Book, Wendy M. Hurst, J. Willis Parks, W. James Hopkins, Katherine L. |
| description | Background: Right ventricular dysfunction occurs in many patients with significant pulmonary valve regurgitation late after initial total repair of tetralogy of Fallot. Methods to predict which of these patients are at increased risk of late morbidity and mortality are not yet known.
Hypothesis: This study evaluated electrocardiographic (ECG) predictors of severe right ventricular dilatation determined by magnetic resonance imaging (MRI) volumes in patients with tetralogy of Fallot late after initial corrective repair.
Method: We retrospectively reviewed the ECGs and MRI right ventricular volume measurements of 20 patients (age 4.4 to 19.3 years, mean 10.0 years) with significant pulmonary valve regurgitation late after repair of tetralogy of Fallot. All patients had enlarged, hypokinetic right ventricles by echocardiography. The patients were grouped based on an indexed right ventricular end‐diastolic volume (RVEDV/BSA) of |
| doi_str_mv | 10.1002/clc.4960221113 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6656030</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>69261545</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4653-e803cc2fd191b5323e7c3375418906ac26c590fd837c638727a159bc30c0dccf3</originalsourceid><addsrcrecordid>eNqFkUuP0zAUhS0EYjoDW5bIC8QuxY_YiTdIqBoYpEpsYG25N05q5MTBdjrqz-Af46oVU1as_Pruucf3IPSGkjUlhH0AD-taScIYpZQ_QyuqOKvahjfP0YpQSSrFWnWDblP6WXjSMv4S3VAiRC0VWaHf995CjgFM7FwYopn3DvAcbecgh5hw6HF0wz7jg51ydLB4E_Eh-GW0eLQmLQXFuyMezTDZXGqjTWEyE1jsyp2bBuxNttj02UacQza-ILNx8SSdbY7Gh-F4OvTG-5BfoRdlk-zry3qHfny-_755qLbfvnzdfNpWUEvBK9sSDsD6jiq6E5xx2wDnjahpq4g0wCQIRfqu5Q1I3jasMVSoHXACpAPo-R36eNadl91oOzh9z3g9x2I7HnUwTv_7Mrm9HsJBSykk4aQIvL8IxPBrsSnr0SWw3pvJhiVpqZikohYFXJ9BiCGlaPu_TSjRpxR1SVE_pVgK3l5bu8LPsRXg3QUwCYzvY5m3S0-cKjNoZMHUGXt03h7_01VvtpsrD38AMZ66Sg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>69261545</pqid></control><display><type>article</type><title>Electrocardiographic predictors of right ventricular volume measured by magnetic resonance imaging late after total repair of tetralogy of fallot</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><creator>Book, Wendy M. ; Hurst, J. Willis ; Parks, W. James ; Hopkins, Katherine L.</creator><creatorcontrib>Book, Wendy M. ; Hurst, J. Willis ; Parks, W. James ; Hopkins, Katherine L.</creatorcontrib><description>Background: Right ventricular dysfunction occurs in many patients with significant pulmonary valve regurgitation late after initial total repair of tetralogy of Fallot. Methods to predict which of these patients are at increased risk of late morbidity and mortality are not yet known.
Hypothesis: This study evaluated electrocardiographic (ECG) predictors of severe right ventricular dilatation determined by magnetic resonance imaging (MRI) volumes in patients with tetralogy of Fallot late after initial corrective repair.
Method: We retrospectively reviewed the ECGs and MRI right ventricular volume measurements of 20 patients (age 4.4 to 19.3 years, mean 10.0 years) with significant pulmonary valve regurgitation late after repair of tetralogy of Fallot. All patients had enlarged, hypokinetic right ventricles by echocardiography. The patients were grouped based on an indexed right ventricular end‐diastolic volume (RVEDV/BSA) of <102 ml/m2 (Group 1) or ≥ 102 ml/m2 (Group 2). We determined the sensitivity, specificity, positive and negative predictive values of QRS duration, and mean frontal plane QRS axis for predicting right ventricular volumes.
Results: A maximal QRS duration of ≥ 150 ms or a northwest quadrant frontal plane QRS axis had 85% sensitivity, 86% specificity, 92% positive predictive value, and 75% negative predictive value for predicting an RVEDV/BSA of ≥ 102 ml/m2. The mean QRS duration was significantly longer in Group 2 than in Group 1 patients (156 ms vs. 123 ms, p=0.005).
Conclusions: In patients late after repair of tetralogy of Fallot with significant pulmonary valve regurgitation, a maximal manually measured QRS duration of ≥ 150 ms and/or a frontal plane QRS northwest quadrant axis can predict patients with marked right ventricular enlargement. The presence of either of these findings on the ECG signifies patients who require further evaluation and consideration for pulmonary valve replacement.</description><identifier>ISSN: 0160-9289</identifier><identifier>EISSN: 1932-8737</identifier><identifier>DOI: 10.1002/clc.4960221113</identifier><identifier>PMID: 10554690</identifier><identifier>CODEN: CLCADC</identifier><language>eng</language><publisher>New York: Wiley Periodicals, Inc</publisher><subject>Adolescent ; Adult ; Biological and medical sciences ; Child ; Child, Preschool ; congenital heart disease ; Electrocardiography ; Electrocardiography. Vectocardiography ; Electrodiagnosis. Electric activity recording ; Female ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Postoperative Period ; Pulmonary Valve Insufficiency - physiopathology ; Retrospective Studies ; right bundle‐branch block ; right ventricle ; Sensitivity and Specificity ; Stroke Volume ; Tetralogy of Fallot - physiopathology ; Tetralogy of Fallot - surgery ; ventricular dysfunction</subject><ispartof>Clinical cardiology (Mahwah, N.J.), 1999-11, Vol.22 (11), p.740-746</ispartof><rights>Copyright © 1999 Wiley Periodicals, Inc.</rights><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4653-e803cc2fd191b5323e7c3375418906ac26c590fd837c638727a159bc30c0dccf3</citedby><cites>FETCH-LOGICAL-c4653-e803cc2fd191b5323e7c3375418906ac26c590fd837c638727a159bc30c0dccf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6656030/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6656030/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,1417,27924,27925,45574,45575,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1989076$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10554690$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Book, Wendy M.</creatorcontrib><creatorcontrib>Hurst, J. Willis</creatorcontrib><creatorcontrib>Parks, W. James</creatorcontrib><creatorcontrib>Hopkins, Katherine L.</creatorcontrib><title>Electrocardiographic predictors of right ventricular volume measured by magnetic resonance imaging late after total repair of tetralogy of fallot</title><title>Clinical cardiology (Mahwah, N.J.)</title><addtitle>Clin Cardiol</addtitle><description>Background: Right ventricular dysfunction occurs in many patients with significant pulmonary valve regurgitation late after initial total repair of tetralogy of Fallot. Methods to predict which of these patients are at increased risk of late morbidity and mortality are not yet known.
Hypothesis: This study evaluated electrocardiographic (ECG) predictors of severe right ventricular dilatation determined by magnetic resonance imaging (MRI) volumes in patients with tetralogy of Fallot late after initial corrective repair.
Method: We retrospectively reviewed the ECGs and MRI right ventricular volume measurements of 20 patients (age 4.4 to 19.3 years, mean 10.0 years) with significant pulmonary valve regurgitation late after repair of tetralogy of Fallot. All patients had enlarged, hypokinetic right ventricles by echocardiography. The patients were grouped based on an indexed right ventricular end‐diastolic volume (RVEDV/BSA) of <102 ml/m2 (Group 1) or ≥ 102 ml/m2 (Group 2). We determined the sensitivity, specificity, positive and negative predictive values of QRS duration, and mean frontal plane QRS axis for predicting right ventricular volumes.
Results: A maximal QRS duration of ≥ 150 ms or a northwest quadrant frontal plane QRS axis had 85% sensitivity, 86% specificity, 92% positive predictive value, and 75% negative predictive value for predicting an RVEDV/BSA of ≥ 102 ml/m2. The mean QRS duration was significantly longer in Group 2 than in Group 1 patients (156 ms vs. 123 ms, p=0.005).
Conclusions: In patients late after repair of tetralogy of Fallot with significant pulmonary valve regurgitation, a maximal manually measured QRS duration of ≥ 150 ms and/or a frontal plane QRS northwest quadrant axis can predict patients with marked right ventricular enlargement. The presence of either of these findings on the ECG signifies patients who require further evaluation and consideration for pulmonary valve replacement.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>congenital heart disease</subject><subject>Electrocardiography</subject><subject>Electrocardiography. Vectocardiography</subject><subject>Electrodiagnosis. Electric activity recording</subject><subject>Female</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Postoperative Period</subject><subject>Pulmonary Valve Insufficiency - physiopathology</subject><subject>Retrospective Studies</subject><subject>right bundle‐branch block</subject><subject>right ventricle</subject><subject>Sensitivity and Specificity</subject><subject>Stroke Volume</subject><subject>Tetralogy of Fallot - physiopathology</subject><subject>Tetralogy of Fallot - surgery</subject><subject>ventricular dysfunction</subject><issn>0160-9289</issn><issn>1932-8737</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUuP0zAUhS0EYjoDW5bIC8QuxY_YiTdIqBoYpEpsYG25N05q5MTBdjrqz-Af46oVU1as_Pruucf3IPSGkjUlhH0AD-taScIYpZQ_QyuqOKvahjfP0YpQSSrFWnWDblP6WXjSMv4S3VAiRC0VWaHf995CjgFM7FwYopn3DvAcbecgh5hw6HF0wz7jg51ydLB4E_Eh-GW0eLQmLQXFuyMezTDZXGqjTWEyE1jsyp2bBuxNttj02UacQza-ILNx8SSdbY7Gh-F4OvTG-5BfoRdlk-zry3qHfny-_755qLbfvnzdfNpWUEvBK9sSDsD6jiq6E5xx2wDnjahpq4g0wCQIRfqu5Q1I3jasMVSoHXACpAPo-R36eNadl91oOzh9z3g9x2I7HnUwTv_7Mrm9HsJBSykk4aQIvL8IxPBrsSnr0SWw3pvJhiVpqZikohYFXJ9BiCGlaPu_TSjRpxR1SVE_pVgK3l5bu8LPsRXg3QUwCYzvY5m3S0-cKjNoZMHUGXt03h7_01VvtpsrD38AMZ66Sg</recordid><startdate>19991101</startdate><enddate>19991101</enddate><creator>Book, Wendy M.</creator><creator>Hurst, J. Willis</creator><creator>Parks, W. James</creator><creator>Hopkins, Katherine L.</creator><general>Wiley Periodicals, Inc</general><general>Wiley</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19991101</creationdate><title>Electrocardiographic predictors of right ventricular volume measured by magnetic resonance imaging late after total repair of tetralogy of fallot</title><author>Book, Wendy M. ; Hurst, J. Willis ; Parks, W. James ; Hopkins, Katherine L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4653-e803cc2fd191b5323e7c3375418906ac26c590fd837c638727a159bc30c0dccf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>congenital heart disease</topic><topic>Electrocardiography</topic><topic>Electrocardiography. Vectocardiography</topic><topic>Electrodiagnosis. Electric activity recording</topic><topic>Female</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Postoperative Period</topic><topic>Pulmonary Valve Insufficiency - physiopathology</topic><topic>Retrospective Studies</topic><topic>right bundle‐branch block</topic><topic>right ventricle</topic><topic>Sensitivity and Specificity</topic><topic>Stroke Volume</topic><topic>Tetralogy of Fallot - physiopathology</topic><topic>Tetralogy of Fallot - surgery</topic><topic>ventricular dysfunction</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Book, Wendy M.</creatorcontrib><creatorcontrib>Hurst, J. Willis</creatorcontrib><creatorcontrib>Parks, W. James</creatorcontrib><creatorcontrib>Hopkins, Katherine L.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Book, Wendy M.</au><au>Hurst, J. Willis</au><au>Parks, W. James</au><au>Hopkins, Katherine L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Electrocardiographic predictors of right ventricular volume measured by magnetic resonance imaging late after total repair of tetralogy of fallot</atitle><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle><addtitle>Clin Cardiol</addtitle><date>1999-11-01</date><risdate>1999</risdate><volume>22</volume><issue>11</issue><spage>740</spage><epage>746</epage><pages>740-746</pages><issn>0160-9289</issn><eissn>1932-8737</eissn><coden>CLCADC</coden><abstract>Background: Right ventricular dysfunction occurs in many patients with significant pulmonary valve regurgitation late after initial total repair of tetralogy of Fallot. Methods to predict which of these patients are at increased risk of late morbidity and mortality are not yet known.
Hypothesis: This study evaluated electrocardiographic (ECG) predictors of severe right ventricular dilatation determined by magnetic resonance imaging (MRI) volumes in patients with tetralogy of Fallot late after initial corrective repair.
Method: We retrospectively reviewed the ECGs and MRI right ventricular volume measurements of 20 patients (age 4.4 to 19.3 years, mean 10.0 years) with significant pulmonary valve regurgitation late after repair of tetralogy of Fallot. All patients had enlarged, hypokinetic right ventricles by echocardiography. The patients were grouped based on an indexed right ventricular end‐diastolic volume (RVEDV/BSA) of <102 ml/m2 (Group 1) or ≥ 102 ml/m2 (Group 2). We determined the sensitivity, specificity, positive and negative predictive values of QRS duration, and mean frontal plane QRS axis for predicting right ventricular volumes.
Results: A maximal QRS duration of ≥ 150 ms or a northwest quadrant frontal plane QRS axis had 85% sensitivity, 86% specificity, 92% positive predictive value, and 75% negative predictive value for predicting an RVEDV/BSA of ≥ 102 ml/m2. The mean QRS duration was significantly longer in Group 2 than in Group 1 patients (156 ms vs. 123 ms, p=0.005).
Conclusions: In patients late after repair of tetralogy of Fallot with significant pulmonary valve regurgitation, a maximal manually measured QRS duration of ≥ 150 ms and/or a frontal plane QRS northwest quadrant axis can predict patients with marked right ventricular enlargement. The presence of either of these findings on the ECG signifies patients who require further evaluation and consideration for pulmonary valve replacement.</abstract><cop>New York</cop><pub>Wiley Periodicals, Inc</pub><pmid>10554690</pmid><doi>10.1002/clc.4960221113</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical cardiology (Mahwah, N.J.), 1999-11, Vol.22 (11), p.740-746 |
| issn | 0160-9289 1932-8737 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Adolescent Adult Biological and medical sciences Child Child, Preschool congenital heart disease Electrocardiography Electrocardiography. Vectocardiography Electrodiagnosis. Electric activity recording Female Humans Investigative techniques, diagnostic techniques (general aspects) Magnetic Resonance Imaging Male Medical sciences Postoperative Period Pulmonary Valve Insufficiency - physiopathology Retrospective Studies right bundle‐branch block right ventricle Sensitivity and Specificity Stroke Volume Tetralogy of Fallot - physiopathology Tetralogy of Fallot - surgery ventricular dysfunction |
| title | Electrocardiographic predictors of right ventricular volume measured by magnetic resonance imaging late after total repair of tetralogy of fallot |
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