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Ultrasonic Assessment of Myocardial Microstructure
10:53

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[In dilated cardiomyopathy normal signal-averaged electrocardiogram does not identify low mortality risk patients]

Maciej Karcz1, Lidia Chojnowska, Wojciech Zareba

  • 1I Klinika Choroby Wieńcowej, Instytut Kardiologii, Warszawa.

Polski Merkuriusz Lekarski : Organ Polskiego Towarzystwa Lekarskiego
|April 3, 2004
PubMed

Insights

Signal-averaged electrocardiogram (SAECG) is not a reliable predictor of cardiac events in patients with idiopathic dilated cardiomyopathy (DCM) and severely reduced left ventricular function. This noninvasive test did not differentiate low-risk individuals from those experiencing adverse cardiac events.

Area of Science:

  • Cardiology
  • Electrophysiology

Context:

  • Survivors of myocardial infarction with normal signal-averaged electrocardiogram (SAECG) have a low risk of death.
  • Idiopathic dilated cardiomyopathy (DCM) is characterized by markedly depressed left ventricular function.

Purpose:

  • To evaluate the utility of time-domain SAECG in identifying low-risk individuals among patients with idiopathic DCM and severely impaired left ventricular function.

Summary:

  • This study performed time-domain SAECG on 67 DCM patients with reduced ejection fraction and followed them for cardiac events (death or transplantation).
  • No significant differences were found in SAECG parameters (fQRS, LAS, RMS) or the incidence of abnormal SAECG between patients with and without cardiac events.
  • Event-free survival curves did not differ significantly based on SAECG results, including specific thresholds for fQRS, LAS, and RMS.

Impact:

  • Normal time-domain SAECG is likely not useful for risk stratification in DCM patients with severely depressed left ventricular function.
  • This finding suggests alternative or additional risk assessment tools may be necessary for this patient population.

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