High-Risk Electrocardiographic Parameters are Ubiquitous in Patients with Ischemic Cardiomyopathy

被引:7
作者
Carey, Mary G. [1 ,2 ]
Al-Zaiti, Salah S. [1 ]
Canty, John M., Jr. [2 ,3 ,4 ,5 ,6 ]
Fallavollita, James A. [2 ,3 ,4 ]
机构
[1] SUNY Buffalo, Sch Nursing, Buffalo, NY 14214 USA
[2] SUNY Buffalo, Ctr Res Cardiovasc Med, Buffalo, NY 14214 USA
[3] SUNY Buffalo, VA WNY Hlth Care Syst Buffalo, Buffalo, NY 14214 USA
[4] SUNY Buffalo, Dept Med, Buffalo, NY 14214 USA
[5] SUNY Buffalo, Dept Physiol & Biophys, Buffalo, NY 14214 USA
[6] SUNY Buffalo, Dept Biomed Engn, Buffalo, NY 14214 USA
基金
美国国家卫生研究院;
关键词
electrocardiography; ischemic cardiomyopathy; high-risk; cardiac death; HEART-ASSOCIATION ELECTROCARDIOGRAPHY; OF-CARDIOLOGY FOUNDATION; SUDDEN CARDIAC DEATH; QRS-T ANGLE; FOR-COMPUTERIZED-ELECTROCARDIOLOGY; STANDARD 12-LEAD ELECTROCARDIOGRAM; SCIENTIFIC STATEMENT; CLINICAL CARDIOLOGY; CARDIOVASCULAR MORTALITY; RHYTHM SOCIETY;
D O I
10.1111/j.1542-474X.2012.00506.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The electrocardiogram (ECG) can be used to predict cardiovascular risk; however, like all risk factors with imperfect specificity, studies in low risk populations have been plagued by poor predictive accuracy. Although predictive accuracy might be improved among cohorts with a higher likelihood of cardiovascular events, this would also affect the prevalence of abnormal parameters and their exclusions. Method: To determine the magnitude of these changes in a cohort with ischemic cardiomyopathy we analyzed 15 previously validated high-risk parameters from the resting and ambulatory ECG in subjects enrolled in the Prediction of Arrhythmic Events with Positron Emission Tomography (PAREPET) study (n = 198). Results: Using the published exclusion criteria from the validation studies (i.e., atrial fibrillation, persistent pacing, prolonged QRS), only 4 high-risk ECG parameters (27%) could be evaluated in all subjects and only 42% of subjects could have all 15 ECG parameters assessed. Nevertheless, almost every subject (97%) had at least one abnormal parameter. On average, there were 3.4 +/- 1.8 (range, 08) high-risk ECG parameters per subject among the 11.7 +/- 4.5 (range, 415) parameters that could be assessed. Conclusions: Thus, 34% of all assessable parameters were abnormal. In conclusion, a significant proportion of ECG parameters cannot be assessed in patients with ischemic cardiomyopathy, but high-risk results are ubiquitous. The influence of these issues will be clarified when the results of the PAREPET study are available to actually determine the predictive value of these parameters on cause-specific mortality in a high-risk cohort.
引用
收藏
页码:241 / 251
页数:11
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