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Changes in the amplitude of electrocardiogram QRS complexes during follow-up of heart failure patients.
MedLine Citation:
PMID:  21376341     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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:
Hajime Kataoka; John E Madias
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-2
Journal Detail:
Title:  Journal of electrocardiology     Volume:  -     ISSN:  1532-8430     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Division of Internal Medicine, Nishida Hospital, Oita, Japan.
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