Next Article in Journal
Altered Hemodynamics in the Embryonic Heart Affects Outflow Valve Development
Previous Article in Journal
Rationale for the Cytogenomics of Cardiovascular Malformations Consortium: A Phenotype Intensive Registry Based Approach
Article Menu

Export Article

Open AccessArticle
J. Cardiovasc. Dev. Dis. 2015, 2(2), 93-107; doi:10.3390/jcdd2020093

Advanced Electrocardiography Identifies Left Ventricular Systolic Dysfunction in Non-Ischemic Cardiomyopathy and Tracks Serial Change over Time

1
North Shore hospital, Waitemata District Health Board, Takapuna, 0620 Auckland, New Zealand
2
Clinical Informatics Systems Group, North Shore Hospital, Waitemata District Health Board, Takapuna, 0620 Auckland, New Zealand
3
Theranostics Laboratory, North Shore Hospital, Waitemata District Health Board, Takapuna, 0620 Auckland, New Zealand
4
Auckland Bioengineering Institute, University of Auckland, 0620 Auckland, New Zealand
*
Author to whom correspondence should be addressed.
Academic Editor: Andy Wessels
Received: 29 March 2015 / Revised: 26 April 2015 / Accepted: 30 April 2015 / Published: 13 May 2015
View Full-Text   |   Download PDF [794 KB, uploaded 13 May 2015]   |  

Abstract

Electrocardiogram (ECG)-based detection of left ventricular systolic dysfunction (LVSD) has poor specificity and positive predictive value, even when including major ECG abnormalities, such as left bundle branch block (LBBB) within the criteria for diagnosis. Although machine-read ECG algorithms do not provide information on LVSD, advanced ECG (A-ECG), using multiparameter scores, has superior diagnostic utility to strictly conventional ECG for identifying various cardiac pathologies, including LVSD. Methods: We evaluated the diagnostic utility of A-ECG in a case-control study of 40 patients with LVSD (LV ejection fraction < 50% by echocardiography), due to non-ischemic cardiomyopathy (NICM), and 39 other patients without LVSD. Diagnostic sensitivity and specificity for LVSD were determined after applying a previously validated probabilistic A-ECG score for LVSD to stored standard (10 s) clinical 12L ECGs. In 25 of the NICM patients who had serial ECGs and echocardiograms, changes in the A-ECG score versus in echocardiographic LV ejection fraction were also studied to determine the level of agreement between the two tests. Results: Analyses by A-ECG had a sensitivity of 95% for LVSD (93% if excluding N = 11 patients with LBBB) and specificity of 95%. In the 29 NICM patients without LBBB who had serial ECGs, sensitivity improved to 97% when all ECGs were considered. By comparison, human readers in a busy clinical environment had a sensitivity of 90% and specificity of 63%. A-ECG score trajectories demonstrated improvement, deterioration or no change in LVSD, which agreed with echocardiography, in 76% of cases (n = 25). Conclusion: A-ECG scoring detects LVSD due to NICM with high sensitivity and specificity. Serial A-ECG score trajectories also represent a method for inexpensively demonstrating changes in LVSD. A-ECG scoring may be of particular value in areas where echocardiography is unavailable, or as a gatekeeper for echocardiography. View Full-Text
Keywords: left ventricular systolic dysfunction; advanced ECG; non-ischemic cardiomyopathy; echocardiography left ventricular systolic dysfunction; advanced ECG; non-ischemic cardiomyopathy; echocardiography
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Scifeed alert for new publications

Never miss any articles matching your research from any publisher
  • Get alerts for new papers matching your research
  • Find out the new papers from selected authors
  • Updated daily for 49'000+ journals and 6000+ publishers
  • Define your Scifeed now

SciFeed Share & Cite This Article

MDPI and ACS Style

Johnson, K.; Neilson, S.; To, A.; Amir, N.; Cave, A.; Scott, T.; Orr, M.; Parata, M.; Day, V.; Gladding, P. Advanced Electrocardiography Identifies Left Ventricular Systolic Dysfunction in Non-Ischemic Cardiomyopathy and Tracks Serial Change over Time. J. Cardiovasc. Dev. Dis. 2015, 2, 93-107.

Show more citation formats Show less citations formats

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
J. Cardiovasc. Dev. Dis. EISSN 2308-3425 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top