Global ECG Measures and Cardiac Structure and Function: The ARIC Study (Atherosclerosis Risk in Communities)

Area of Science:

• Cardiology
• Electrophysiology
• Medical Imaging

Background:

• The heart's electrical activity initiates mechanical contraction and pumping.
• Global electric heterogeneity (GEH) refers to variations in the heart's electrical field.
• The relationship between GEH and cardiac structure/function requires further investigation.

Purpose of the Study:

• To investigate the association between ECG-derived global electric heterogeneity (GEH) and cardiac structure and function.
• To assess the longitudinal changes in GEH and their correlation with cardiac remodeling and dysfunction.

Main Methods:

• Utilized data from the ARIC study, including 12-lead ECGs and echocardiographic assessments.
• Quantified GEH using spatial ventricular gradient, QRS-T angle, and sum absolute QRS-T integral.
• Employed cross-sectional and longitudinal regression analyses, adjusting for cardiovascular disease.

Main Results:

• Four abnormal GEH parameters correlated with significant declines in LV ejection fraction and increases in LV mass and volume.
• Clinical and ECG parameters explained approximately one-third of LV volume and 20% of systolic function variability.
• GEH changes were more pronounced in individuals with cardiovascular disease, LV dilatation, or those experiencing sudden cardiac death.

Conclusions:

• Global electric heterogeneity (GEH) serves as a valuable marker for subclinical cardiac structural and functional abnormalities.
• Longitudinal GEH assessment can provide insights into cardiac remodeling and predict adverse cardiac events.
• Specific patterns of GEH changes are associated with healthy aging and pathological cardiac conditions.