PMID- 32329134
OWN - NLM
STAT- MEDLINE
DCOM- 20210824
LR  - 20210824
IS  - 1542-474X (Electronic)
IS  - 1082-720X (Print)
IS  - 1082-720X (Linking)
VI  - 25
IP  - 5
DP  - 2020 Sep
TI  - How are ECG parameters related to cardiac magnetic resonance images? 
      Electrocardiographic predictors of left ventricular hypertrophy and myocardial 
      fibrosis in hypertrophic cardiomyopathy.
PG  - e12763
LID - 10.1111/anec.12763 [doi]
LID - e12763
AB  - BACKGROUND: Structural myocardial changes in hypertrophic cardiomyopathy (HCM) 
      are associated with different abnormalities on electrocardiographs (ECGs). The 
      diagnostic value of the ECG voltage criteria used to screen for left ventricular 
      hypertrophy (LVH) may depend on the presence and degree of myocardial fibrosis. 
      Fibrosis can cause other changes in ECG parameters, such as pathological Q waves, 
      fragmented QRS (fQRS), or repolarization abnormalities. METHODS: We investigated 
      146 patients with HCM and 35 healthy individuals who underwent cardiac magnetic 
      resonance imaging (CMR; with late gadolinium enhancement [LGE] in HCM patients) 
      and standard 12-lead ECGs. On the ECG, depolarization and repolarization 
      abnormalities, the Sokolow-Lyon index, the Cornell index, and the Romhilt-Estes 
      score were evaluated. The left ventricular ejection fraction, volumes, and 
      myocardial mass (LVM) were quantified. Myocardial fibrosis was quantified on LGE 
      images. RESULTS: The sensitivity of the Romhilt-Estes score was the highest 
      (75%), and this hypertrophy criterion had the strongest correlation with the LVM 
      index (p < .0001; r = .41). The amount of fibrosis was negatively correlated with 
      the Cornell index (p = .015; r = -.201) and the Sokolow-Lyon index (p = .005; 
      r = -.23), and the Romhilt-Estes score was independent of fibrosis (p = .757; 
      r = 0.026). fQRS and strain pattern predicted more fibrosis, while the Cornell 
      index was a negative predictor of myocardial fibrosis (p < .0001). Among others, 
      the strain pattern was an independent predictor of the LVM (p < .0001). 
      CONCLUSION: The Romhilt-Estes score is the most sensitive ECG criterion for 
      detecting LVH in HCM patients, as myocardial fibrosis does not affect this 
      criterion. The presence of fQRS and strain pattern predicts myocardial fibrosis.
CI  - (c) 2020 The Authors. Annals of Noninvasive Electrocardiology published by Wiley 
      Periodicals LLC.
FAU - Dohy, Zsofia
AU  - Dohy Z
AD  - Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
FAU - Vereckei, Andras
AU  - Vereckei A
AD  - 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
FAU - Horvath, Viktor
AU  - Horvath V
AD  - Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
FAU - Czimbalmos, Csilla
AU  - Czimbalmos C
AD  - Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
FAU - Szabo, Liliana
AU  - Szabo L
AD  - Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
FAU - Toth, Attila
AU  - Toth A
AD  - Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
FAU - Suhai, Ferenc I
AU  - Suhai FI
AD  - Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
FAU - Csecs, Ibolya
AU  - Csecs I
AD  - Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
FAU - Becker, David
AU  - Becker D
AD  - Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
FAU - Merkely, Bela
AU  - Merkely B
AD  - Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
FAU - Vago, Hajnalka
AU  - Vago H
AUID- ORCID: 0000-0002-3568-3572
AD  - Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200423
PL  - United States
TA  - Ann Noninvasive Electrocardiol
JT  - Annals of noninvasive electrocardiology : the official journal of the 
      International Society for Holter and Noninvasive Electrocardiology, Inc
JID - 9607443
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Adult
MH  - Cardiomyopathy, Hypertrophic/*complications/*pathology
MH  - Contrast Media
MH  - Electrocardiography/*methods
MH  - Female
MH  - Fibrosis
MH  - Gadolinium
MH  - Heart Ventricles/diagnostic imaging
MH  - Humans
MH  - Hypertrophy, Left Ventricular/*complications/*diagnosis/pathology
MH  - Image Enhancement/methods
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Middle Aged
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
PMC - PMC7507346
OTO - NOTNLM
OT  - cardiac magnetic resonance
OT  - electrocardiography
OT  - fragmented QRS
OT  - hypertrophic cardiomyopathy
OT  - myocardial fibrosis
OT  - strain pattern
COIS- The authors have stated explicitly that there are no conflicts of interest in 
      connection with this article.
EDAT- 2020/04/25 06:00
MHDA- 2021/08/25 06:00
PMCR- 2020/04/23
CRDT- 2020/04/25 06:00
PHST- 2020/01/22 00:00 [received]
PHST- 2020/03/09 00:00 [revised]
PHST- 2020/03/22 00:00 [accepted]
PHST- 2020/04/25 06:00 [pubmed]
PHST- 2021/08/25 06:00 [medline]
PHST- 2020/04/25 06:00 [entrez]
PHST- 2020/04/23 00:00 [pmc-release]
AID - ANEC12763 [pii]
AID - 10.1111/anec.12763 [doi]
PST - ppublish
SO  - Ann Noninvasive Electrocardiol. 2020 Sep;25(5):e12763. doi: 10.1111/anec.12763. 
      Epub 2020 Apr 23.