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Validation of electrocardiographic criteria for identifying left ventricular dysfunction in patients with previous myocardial infarction
| Content Provider | Scilit |
|---|---|
| Author | Panicker, Gopi Krishna Narula, Dhiraj D. Albert, Christine M. Lee, Daniel C. Kothari, Snehal Goldberger, Jeffrey J. Cook, Nancy Schaechter, Andi Kim, Eunjung Moorthy, M. Vinayaga Pester, Julie Chatterjee, Neal A. Kadish, Alan H. Karnad, Dilip R. |
| Copyright Year | 2020 |
| Description | Journal: Annals of Noninvasive Electrocardiology Eleven criteria correlating electrocardiogram (ECG) findings with reduced left ventricular ejection fraction (LVEF) have been previously published. These have not been compared head‐to‐head in a single study. We studied their value as a screening test to identify patients with reduced LVEF estimated by cardiac magnetic resonance (CMR) imaging. ECGs and CMR from 548 patients (age 61 + 11 years, 79% male) with previous myocardial infarction (MI), from the DETERMINE and PRE‐DETERMINE studies, were analyzed. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each criterion for identifying patients with LVEF ≤ 30% and ≤ 40% were studied. A useful screening test should have high sensitivity and NPV. Mean LVEF was 40% (SD = 11%); 264 patients (48.2%) had LVEF ≤ 40%, and 96 patients (17.5%) had LVEF ≤ 30%. Six of 11 criteria were associated with a significant lower LVEF, but had poor sensitivity to identify LVEF ≤ 30% (range 2.1%–55.2%) or LVEF ≤ 40% (1.1%–51.1%); NPVs were good for LVEF ≤ 30% (range 82.8%–85.9%) but not for LVEF ≤ 40% (range 52.1%–60.6%). Goldberger's third criterion (RV4/SV4 < 1) and combinations of maximal QRS duration > 124 ms + either Goldberger's third criterion or Goldberger's first criterion (SV1 or SV2 + RV5 or RV6 ≥ 3.5 mV) had high specificity (95.4%–100%) for LVEF ≤ 40%, although seen in only 48 (8.8%) patients; predictive values were similar on subgroup analysis. None of the ECG criteria qualified as a good screening test. Three criteria had high specificity for LVEF ≤ 40%, although seen in < 9% of patients. Whether other ECG criteria can better identify LV dysfunction remains to be determined. |
| ISSN | 00221295 |
| e-ISSN | 1542474X |
| DOI | 10.1111/anec.12812 |
| Journal | Annals of Noninvasive Electrocardiology |
| Issue Number | 2 |
| Volume Number | 26 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2020-10-30 |
| Access Restriction | Open |
| Subject Keyword | Journal: Annals of Noninvasive Electrocardiology Cardiology and Cardiovascular Diseases Cardiac Magnetic Resonance Imaging Coronary Artery Disease Electrocardiology Left Ventricular Ejection Fraction Myocardial Infarction |
| Content Type | Text |
| Resource Type | Article |
| Subject | Physiology |
