Document Detail


Response of the ECG to short-term diuresis in patients with heart failure.
MedLine Citation:
PMID:  16029379     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Increase in the amplitude of electrocardiogram (ECG) QRS complexes has been observed in patients treated for heart failure (HF), but the underlying mechanism has not been delineated. Also, correlation of augmentation of the QRS potentials with loss of weight has been noted in patients recovering from anasarca of varying etiology, or after hemodialysis. We assessed the effect of diuresis-based fluid loss in patients treated for HF on the amplitude of ECG QRS complexes. METHODS: This is a cohort study based on ECG and other data from a previously published investigation of patients with HF conducted at a university affiliated hospital, which used new measurements and analysis, performed by a totally blinded investigator based at another institution. Twenty-one patients (10 men) aged 70.5+/-12.7 years, 13 with ischemic, and 8 with nonischemic cardiomyopathy, were admitted to the hospital for management of exacerbated HF and were observed for 48 hours. The patients received diuresis, and had routine laboratory testing, documentation of the net fluid lost, and recording of ECGs prior to the initiation of therapy and at 24 and 48 hours. Percent change (%Delta) over the course of observation in the sums of the amplitude of QRS complexes from 12 leads (SigmaQRS12), 6-limb leads (SigmaQRS6), and leads 1+2 (SigmaQRS2) in mm of standard ECGs were correlated with net fluid loss corrected for admission weight in mL/kg. RESULTS: Fluid loss amounted to 3204.9+/-1399.5 mL in the course of 40+/-23 hours of diuresis. SigmaQRS12 was 160.9+/-42.3 mm before and 170.0+/-50.7 mm after diuresis (P=0. 024). Percent change in SigmaQRS12, SigmaQRS6, and SigmaQRS2 correlated well with the net fluid loss (r=-0.70, -0.82, -0.61, and P=0.002, 0.0005, 0.001) correspondingly. CONCLUSION: Changes in sums of the amplitude of QRS complexes of the standard ECG correlates well with net fluid loss in response to short-term diuresis in patients with HF. Change in the SigmaQRS12, SigmaQRS6, and SigmaQRS2 from ECGs before and after diuresis can be used as an easily obtainable and universally available bedside index of the net fluid loss experienced by bedridden patients with HF undergoing therapy.
Authors:
John E Madias; Jessica Song; C Michael White; James S Kalus; Jeffrey Kluger
Related Documents :
9220309 - Human leukocyte antigen class ii associations in patients with idiopathic dilated cardi...
19375919 - Idiopathic hypertrophic cranial pachymeningitis and dural sinus occlusion: two patients...
2683709 - Clinical characteristics and outcome of acute myocardial infarction in patients with in...
9355899 - Arrhythmogenic marker for the sudden unexplained death syndrome in thai men.
21436949 - Systemic sclerosis in a patient with pityriasis rubra pilaris.
11466139 - Is qt dispersion associated with sudden cardiac death in patients with hypertrophic car...
23401129 - Natalizumab in pediatric multiple sclerosis: results of a cohort of 55 cases.
17453639 - A comparison of maximal inspiratory pressure and forced vital capacity as potential cri...
10428589 - Bilateral inferior rectus muscle recession for correction of hypotropia in dysthyroid o...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc     Volume:  10     ISSN:  1082-720X     ISO Abbreviation:  Ann Noninvasive Electrocardiol     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-20     Completed Date:  2005-11-10     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  9607443     Medline TA:  Ann Noninvasive Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  288-96     Citation Subset:  IM    
Affiliation:
Mount Sinai School of Medicine, Division of Cardiology, Elmhurst Hospital Center, Elmhurst, NY 11373, USA. madiasj@nychhc.org
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Diuretics / administration & dosage*
Electrocardiography
Female
Heart Failure / drug therapy*,  physiopathology*
Humans
Male
Regression Analysis
Chemical
Reg. No./Substance:
0/Diuretics

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Usefulness of seismocardiography for the diagnosis of ischemia in patients with coronary artery dise...
Next Document:  Abnormalities of ventricular repolarization in mitral valve prolapse.