Electrocardiographic predictors of myocardial fibrosis and apical hypertrophic cardiomyopathy
Background Electrocardiography (ECG) may be an efficacious diagnostic and prognostic tool in hypertrophic cardiomyopathy (HCM). This study aimed to investigate association between deep T‐wave inversion (TWI) and apical HCM, and between fragmented QRS (fQRS) complex and myocardial fibrosis in patient...
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| Veröffentlicht in: | Annals of noninvasive electrocardiology 2019-03, Vol.24 (2), p.e12612-n/a |
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| creator | Tangwiwat, Chayapat Kaolawanich, Yodying Krittayaphong, Rungroj |
| description | Background
Electrocardiography (ECG) may be an efficacious diagnostic and prognostic tool in hypertrophic cardiomyopathy (HCM). This study aimed to investigate association between deep T‐wave inversion (TWI) and apical HCM, and between fragmented QRS (fQRS) complex and myocardial fibrosis in patients with HCM.
Methods
Patients with documented HCM by cardiac magnetic resonance imaging (CMR) during 2005–2015 were studied. The 12‐lead ECG and CMR were performed on the same day. All patients underwent CMR for the assessment of cardiac structure, function, and late gadolinium enhancement (LGE). LGE was used to detect myocardial fibrosis.
Results
One hundred forty‐four HCM (mean age 66 ± 15.8 years, 60.4% male) were included. Twenty‐nine (20.14%) subjects had deep TWI, and apical HCM was found in 76 (52.78%). Deep TWI was associated with apical HCM with the Odds ratio (95%CI) of 5.82 (2.07, 16.04) and p |
| doi_str_mv | 10.1111/anec.12612 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6931658</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2189192144</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4482-49903b51b280ac830ebb5aa786fde212f19e6821cca799b211a773528f848dc13</originalsourceid><addsrcrecordid>eNp9kc9r2zAUx0Xp6I90l_4BxbBLKaTTe5Zt6VIoId0GZbtskEsRsiw3Ko7lSk6L__spcRbaHaqLhN5HH57el5BzoNcQ11fVGn0NmAMekBPIGE5ZwRaH8Uw5Tguki2NyGsITpYgMiyNynFJGU8bghDzMG6N777TylXWPXnVLq5POm8rq3vmQuDpZDWNZNUltS--CDYlqq0R1Vse75dAZHxXbl6MnvuhUvxzOyKdaNcF83u0T8udu_nv2fXr_69uP2e39VDMWW2RC0LTMoEROleYpNWWZKVXwvK4MAtYgTM4RtFaFECUCqKJIM-Q1Z7zSkE7Izejt1uXKVNq0vVeN7LxdKT9Ip6x8X2ntUj66F5mLFPKMR8HlTuDd89qEXq5s0KZp4mzdOkiElHKaMYER_fIf-uTWvo3fixQXIBAYi9TVSOk4r-BNvW8GqNykJjepyW1qEb542_4e_RdTBGAEXm1jhg9U8vbnfDZK_wLKuKQ8</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2189192144</pqid></control><display><type>article</type><title>Electrocardiographic predictors of myocardial fibrosis and apical hypertrophic cardiomyopathy</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Tangwiwat, Chayapat ; Kaolawanich, Yodying ; Krittayaphong, Rungroj</creator><creatorcontrib>Tangwiwat, Chayapat ; Kaolawanich, Yodying ; Krittayaphong, Rungroj</creatorcontrib><description>Background
Electrocardiography (ECG) may be an efficacious diagnostic and prognostic tool in hypertrophic cardiomyopathy (HCM). This study aimed to investigate association between deep T‐wave inversion (TWI) and apical HCM, and between fragmented QRS (fQRS) complex and myocardial fibrosis in patients with HCM.
Methods
Patients with documented HCM by cardiac magnetic resonance imaging (CMR) during 2005–2015 were studied. The 12‐lead ECG and CMR were performed on the same day. All patients underwent CMR for the assessment of cardiac structure, function, and late gadolinium enhancement (LGE). LGE was used to detect myocardial fibrosis.
Results
One hundred forty‐four HCM (mean age 66 ± 15.8 years, 60.4% male) were included. Twenty‐nine (20.14%) subjects had deep TWI, and apical HCM was found in 76 (52.78%). Deep TWI was associated with apical HCM with the Odds ratio (95%CI) of 5.82 (2.07, 16.04) and p < 0.001 in univariate analysis model. The association was still significant in multivariate analysis with adjusted Odds ratio (95%CI) of 9.86 (3.17, 30.66), p < 0.001. Forty‐seven (32.64%) subjects had fQRS complex, and myocardial fibrosis was detected in 101 (70.14%). fQRS complex was found to be associated with myocardial fibrosis in univariate analysis with the Odds ratio (95%CI) = 2.75 (1.16, 6.54), p = 0.019. However, the association cannot be demonstrated in the multivariate analysis.
Conclusion
Deep TWI is independently associated with apical HCM, but the relationship between fQRS complex and myocardial fibrosis did not survive multivariate analysis.</description><identifier>ISSN: 1082-720X</identifier><identifier>EISSN: 1542-474X</identifier><identifier>DOI: 10.1111/anec.12612</identifier><identifier>PMID: 30403441</identifier><language>eng</language><publisher>United States: John Wiley & Sons, Inc</publisher><subject>Adult ; Age Factors ; Aged ; Analysis of Variance ; apical hypertrophic cardiomyopathy ; Cardiomyopathy ; Cardiomyopathy, Hypertrophic - diagnostic imaging ; Cardiomyopathy, Hypertrophic - epidemiology ; Cardiomyopathy, Hypertrophic - pathology ; Cohort Studies ; Comorbidity ; Diagnostic software ; Diagnostic systems ; ECG ; Echocardiography ; EKG ; electrocardiographic predictors ; Electrocardiography ; Electrocardiography - methods ; Female ; Fibrosis ; Fibrosis - diagnostic imaging ; Fibrosis - epidemiology ; Fibrosis - pathology ; Gadolinium ; Heart ; Humans ; Magnetic resonance imaging ; Magnetic Resonance Imaging, Cine - methods ; Male ; Middle Aged ; Multivariate Analysis ; myocardial fibrosis ; Original ; Patients ; Prevalence ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Sex Factors ; Structure-function relationships ; Survival Rate ; Thailand - epidemiology</subject><ispartof>Annals of noninvasive electrocardiology, 2019-03, Vol.24 (2), p.e12612-n/a</ispartof><rights>2018 Wiley Periodicals, Inc.</rights><rights>2019 European Society of Cardiology and Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4482-49903b51b280ac830ebb5aa786fde212f19e6821cca799b211a773528f848dc13</citedby><cites>FETCH-LOGICAL-c4482-49903b51b280ac830ebb5aa786fde212f19e6821cca799b211a773528f848dc13</cites><orcidid>0000-0001-8684-2361</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6931658/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6931658/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,1411,27901,27902,45550,45551,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30403441$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tangwiwat, Chayapat</creatorcontrib><creatorcontrib>Kaolawanich, Yodying</creatorcontrib><creatorcontrib>Krittayaphong, Rungroj</creatorcontrib><title>Electrocardiographic predictors of myocardial fibrosis and apical hypertrophic cardiomyopathy</title><title>Annals of noninvasive electrocardiology</title><addtitle>Ann Noninvasive Electrocardiol</addtitle><description>Background
Electrocardiography (ECG) may be an efficacious diagnostic and prognostic tool in hypertrophic cardiomyopathy (HCM). This study aimed to investigate association between deep T‐wave inversion (TWI) and apical HCM, and between fragmented QRS (fQRS) complex and myocardial fibrosis in patients with HCM.
Methods
Patients with documented HCM by cardiac magnetic resonance imaging (CMR) during 2005–2015 were studied. The 12‐lead ECG and CMR were performed on the same day. All patients underwent CMR for the assessment of cardiac structure, function, and late gadolinium enhancement (LGE). LGE was used to detect myocardial fibrosis.
Results
One hundred forty‐four HCM (mean age 66 ± 15.8 years, 60.4% male) were included. Twenty‐nine (20.14%) subjects had deep TWI, and apical HCM was found in 76 (52.78%). Deep TWI was associated with apical HCM with the Odds ratio (95%CI) of 5.82 (2.07, 16.04) and p < 0.001 in univariate analysis model. The association was still significant in multivariate analysis with adjusted Odds ratio (95%CI) of 9.86 (3.17, 30.66), p < 0.001. Forty‐seven (32.64%) subjects had fQRS complex, and myocardial fibrosis was detected in 101 (70.14%). fQRS complex was found to be associated with myocardial fibrosis in univariate analysis with the Odds ratio (95%CI) = 2.75 (1.16, 6.54), p = 0.019. However, the association cannot be demonstrated in the multivariate analysis.
Conclusion
Deep TWI is independently associated with apical HCM, but the relationship between fQRS complex and myocardial fibrosis did not survive multivariate analysis.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Analysis of Variance</subject><subject>apical hypertrophic cardiomyopathy</subject><subject>Cardiomyopathy</subject><subject>Cardiomyopathy, Hypertrophic - diagnostic imaging</subject><subject>Cardiomyopathy, Hypertrophic - epidemiology</subject><subject>Cardiomyopathy, Hypertrophic - pathology</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Diagnostic software</subject><subject>Diagnostic systems</subject><subject>ECG</subject><subject>Echocardiography</subject><subject>EKG</subject><subject>electrocardiographic predictors</subject><subject>Electrocardiography</subject><subject>Electrocardiography - methods</subject><subject>Female</subject><subject>Fibrosis</subject><subject>Fibrosis - diagnostic imaging</subject><subject>Fibrosis - epidemiology</subject><subject>Fibrosis - pathology</subject><subject>Gadolinium</subject><subject>Heart</subject><subject>Humans</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging, Cine - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>myocardial fibrosis</subject><subject>Original</subject><subject>Patients</subject><subject>Prevalence</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>Sex Factors</subject><subject>Structure-function relationships</subject><subject>Survival Rate</subject><subject>Thailand - epidemiology</subject><issn>1082-720X</issn><issn>1542-474X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc9r2zAUx0Xp6I90l_4BxbBLKaTTe5Zt6VIoId0GZbtskEsRsiw3Ko7lSk6L__spcRbaHaqLhN5HH57el5BzoNcQ11fVGn0NmAMekBPIGE5ZwRaH8Uw5Tguki2NyGsITpYgMiyNynFJGU8bghDzMG6N777TylXWPXnVLq5POm8rq3vmQuDpZDWNZNUltS--CDYlqq0R1Vse75dAZHxXbl6MnvuhUvxzOyKdaNcF83u0T8udu_nv2fXr_69uP2e39VDMWW2RC0LTMoEROleYpNWWZKVXwvK4MAtYgTM4RtFaFECUCqKJIM-Q1Z7zSkE7Izejt1uXKVNq0vVeN7LxdKT9Ip6x8X2ntUj66F5mLFPKMR8HlTuDd89qEXq5s0KZp4mzdOkiElHKaMYER_fIf-uTWvo3fixQXIBAYi9TVSOk4r-BNvW8GqNykJjepyW1qEb542_4e_RdTBGAEXm1jhg9U8vbnfDZK_wLKuKQ8</recordid><startdate>201903</startdate><enddate>201903</enddate><creator>Tangwiwat, Chayapat</creator><creator>Kaolawanich, Yodying</creator><creator>Krittayaphong, Rungroj</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><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>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8684-2361</orcidid></search><sort><creationdate>201903</creationdate><title>Electrocardiographic predictors of myocardial fibrosis and apical hypertrophic cardiomyopathy</title><author>Tangwiwat, Chayapat ; Kaolawanich, Yodying ; Krittayaphong, Rungroj</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4482-49903b51b280ac830ebb5aa786fde212f19e6821cca799b211a773528f848dc13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Analysis of Variance</topic><topic>apical hypertrophic cardiomyopathy</topic><topic>Cardiomyopathy</topic><topic>Cardiomyopathy, Hypertrophic - diagnostic imaging</topic><topic>Cardiomyopathy, Hypertrophic - epidemiology</topic><topic>Cardiomyopathy, Hypertrophic - pathology</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>Diagnostic software</topic><topic>Diagnostic systems</topic><topic>ECG</topic><topic>Echocardiography</topic><topic>EKG</topic><topic>electrocardiographic predictors</topic><topic>Electrocardiography</topic><topic>Electrocardiography - methods</topic><topic>Female</topic><topic>Fibrosis</topic><topic>Fibrosis - diagnostic imaging</topic><topic>Fibrosis - epidemiology</topic><topic>Fibrosis - pathology</topic><topic>Gadolinium</topic><topic>Heart</topic><topic>Humans</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging, Cine - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>myocardial fibrosis</topic><topic>Original</topic><topic>Patients</topic><topic>Prevalence</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>Sex Factors</topic><topic>Structure-function relationships</topic><topic>Survival Rate</topic><topic>Thailand - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tangwiwat, Chayapat</creatorcontrib><creatorcontrib>Kaolawanich, Yodying</creatorcontrib><creatorcontrib>Krittayaphong, Rungroj</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of noninvasive electrocardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tangwiwat, Chayapat</au><au>Kaolawanich, Yodying</au><au>Krittayaphong, Rungroj</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Electrocardiographic predictors of myocardial fibrosis and apical hypertrophic cardiomyopathy</atitle><jtitle>Annals of noninvasive electrocardiology</jtitle><addtitle>Ann Noninvasive Electrocardiol</addtitle><date>2019-03</date><risdate>2019</risdate><volume>24</volume><issue>2</issue><spage>e12612</spage><epage>n/a</epage><pages>e12612-n/a</pages><issn>1082-720X</issn><eissn>1542-474X</eissn><abstract>Background
Electrocardiography (ECG) may be an efficacious diagnostic and prognostic tool in hypertrophic cardiomyopathy (HCM). This study aimed to investigate association between deep T‐wave inversion (TWI) and apical HCM, and between fragmented QRS (fQRS) complex and myocardial fibrosis in patients with HCM.
Methods
Patients with documented HCM by cardiac magnetic resonance imaging (CMR) during 2005–2015 were studied. The 12‐lead ECG and CMR were performed on the same day. All patients underwent CMR for the assessment of cardiac structure, function, and late gadolinium enhancement (LGE). LGE was used to detect myocardial fibrosis.
Results
One hundred forty‐four HCM (mean age 66 ± 15.8 years, 60.4% male) were included. Twenty‐nine (20.14%) subjects had deep TWI, and apical HCM was found in 76 (52.78%). Deep TWI was associated with apical HCM with the Odds ratio (95%CI) of 5.82 (2.07, 16.04) and p < 0.001 in univariate analysis model. The association was still significant in multivariate analysis with adjusted Odds ratio (95%CI) of 9.86 (3.17, 30.66), p < 0.001. Forty‐seven (32.64%) subjects had fQRS complex, and myocardial fibrosis was detected in 101 (70.14%). fQRS complex was found to be associated with myocardial fibrosis in univariate analysis with the Odds ratio (95%CI) = 2.75 (1.16, 6.54), p = 0.019. However, the association cannot be demonstrated in the multivariate analysis.
Conclusion
Deep TWI is independently associated with apical HCM, but the relationship between fQRS complex and myocardial fibrosis did not survive multivariate analysis.</abstract><cop>United States</cop><pub>John Wiley & Sons, Inc</pub><pmid>30403441</pmid><doi>10.1111/anec.12612</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-8684-2361</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Age Factors Aged Analysis of Variance apical hypertrophic cardiomyopathy Cardiomyopathy Cardiomyopathy, Hypertrophic - diagnostic imaging Cardiomyopathy, Hypertrophic - epidemiology Cardiomyopathy, Hypertrophic - pathology Cohort Studies Comorbidity Diagnostic software Diagnostic systems ECG Echocardiography EKG electrocardiographic predictors Electrocardiography Electrocardiography - methods Female Fibrosis Fibrosis - diagnostic imaging Fibrosis - epidemiology Fibrosis - pathology Gadolinium Heart Humans Magnetic resonance imaging Magnetic Resonance Imaging, Cine - methods Male Middle Aged Multivariate Analysis myocardial fibrosis Original Patients Prevalence Retrospective Studies Risk Assessment Severity of Illness Index Sex Factors Structure-function relationships Survival Rate Thailand - epidemiology |
| title | Electrocardiographic predictors of myocardial fibrosis and apical hypertrophic cardiomyopathy |
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