INTRODUCTION: Changes in the electrocardiogram QRS amplitudes (ECGΔ) during follow-up of heart failure (HF) patients have not been clinically exploited heretofore. METHODS: We examined ECGΔ during follow-up of HF patients by employing 42 triplets of ECGs, other laboratory and HF-related clinical data corresponding to clinical stability, worsening, and recovery from 37 HF patients. RESULTS: The % changes (Δ%) in the summed QRS amplitude of all 12 leads (ΣQRS(12L)), 6 precordial leads (ΣQRS(V1-V6)), 6 limb leads (ΣQRS(6L)), leads I+II (ΣQRS(I + II)), and lead aVR were evaluated. Also relationships between the ECG variables and body weight (BW), percent body-fat, and B-type natriuretic peptide (BNP) were examined. The QRS amplitude(s) in all ECG variables decreased from clinical stability to worsening HF, and returned to baseline at recovery. During HF worsening, Δ% was highest in lead aVR (-15.3 ± 12.3%), followed by Δ% in ΣQRS(6L) (-12.9 ± 10.1%) and ΣQRS(I + II) (-12.1 ± 10.8%). At worsening HF and its recovery, Δ% in ΣQRS(6L) correlated with Δ% in percent body-fat (r = 0.333, P = .031; r = 0.308, P = .047). At recovery, Δ% in each ECG variable correlated with Δ% in BW. Receiver operating characteristic (ROC) analysis showed that ≥16% reduction of ΣQRS(6L) and ΣQRS(I + II) discriminated between stable and worsening HF, with a sensitivity of 43% and 40%, and specificity of 98% for both. ECG variables from limb lead(s) had as good area under the curve (AUC) (0.78-0.84) as BNP (AUC: 0.88) for identifying worsening HF. CONCLUSIONS: Changes of the QRS amplitudes in ECGs are as useful for monitoring HF patients as BNP.
INTRODUCTION: Changes in the electrocardiogram QRS amplitudes (ECGΔ) during follow-up of heart failure (HF) patients have not been clinically exploited heretofore. METHODS: We examined ECGΔ during follow-up of HF patients by employing 42 triplets of ECGs, other laboratory and HF-related clinical data corresponding to clinical stability, worsening, and recovery from 37 HF patients. RESULTS: The % changes (Δ%) in the summed QRS amplitude of all 12 leads (ΣQRS(12L)), 6 precordial leads (ΣQRS(V1-V6)), 6 limb leads (ΣQRS(6L)), leads I+II (ΣQRS(I + II)), and lead aVR were evaluated. Also relationships between the ECG variables and body weight (BW), percent body-fat, and B-type natriuretic peptide (BNP) were examined. The QRS amplitude(s) in all ECG variables decreased from clinical stability to worsening HF, and returned to baseline at recovery. During HF worsening, Δ% was highest in lead aVR (-15.3 ± 12.3%), followed by Δ% in ΣQRS(6L) (-12.9 ± 10.1%) and ΣQRS(I + II) (-12.1 ± 10.8%). At worsening HF and its recovery, Δ% in ΣQRS(6L) correlated with Δ% in percent body-fat (r = 0.333, P = .031; r = 0.308, P = .047). At recovery, Δ% in each ECG variable correlated with Δ% in BW. Receiver operating characteristic (ROC) analysis showed that ≥16% reduction of ΣQRS(6L) and ΣQRS(I + II) discriminated between stable and worsening HF, with a sensitivity of 43% and 40%, and specificity of 98% for both. ECG variables from limb lead(s) had as good area under the curve (AUC) (0.78-0.84) as BNP (AUC: 0.88) for identifying worsening HF. CONCLUSIONS: Changes of the QRS amplitudes in ECGs are as useful for monitoring HF patients as BNP.
Authors: Wern Yew Ding; Robert Cooper; Derick Todd; Dhiraj Gupta; Mark Hall; Archana Rao; Jay Wright; Richard Snowdon; Johan Waktare; Simon Modi Journal: J Interv Card Electrophysiol Date: 2018-06-13 Impact factor: 1.900
Authors: Christos Zormpas; Jörg Eiringhaus; Henrike A K Hillmann; Stephan Hohmann; Johanna Müller-Leisse; Jan D Schmitto; Christian Veltmann; David Duncker Journal: J Interv Card Electrophysiol Date: 2020-07-01 Impact factor: 1.900
Authors: Anne-Mar Van Ommen; Elise Laura Kessler; Gideon Valstar; N Charlotte Onland-Moret; Maarten Jan Cramer; Frans Rutten; Ruben Coronel; Hester Den Ruijter Journal: Front Cardiovasc Med Date: 2021-12-17