Electrical surrogate for detection of severe left ventricular systolic dysfunction

Area of Science:

• Cardiology
• Medical Diagnostics
• Biomedical Engineering

Background:

• Early diagnosis and treatment of heart failure with severely reduced left ventricular ejection fraction (LVEF ≤35%) improve patient outcomes.
• Some individuals with severely reduced LVEF may remain undiagnosed.
• Electrocardiogram (ECG) markers may offer a novel approach to identify these patients.

Purpose of the Study:

• To investigate if a combination of ECG markers can identify individuals with severely reduced LVEF (≤35%).
• To evaluate the diagnostic potential of an expanded panel of ECG markers for reduced LVEF.

Main Methods:

• Utilized data from the Oregon Sudden Unexpected Death Study (discovery population) and a large health system in Los Angeles (validation population).
• Assessed conventional ECG markers and an expanded panel of nine additional ECG markers in relation to LVEF.
• Validated the correlation between ECG markers and LVEF in separate patient cohorts.

Main Results:

• Patients with LVEF ≤35% were more likely to have conventional ECG abnormalities compared to those with LVEF >35%.
• In patients without conventional ECG abnormalities, an expanded panel of ≥4 abnormal ECG markers identified a higher proportion with LVEF ≤35% in both discovery (12% vs 1%) and validation (40% vs 5%) populations.
• Each additional abnormal ECG marker from the expanded panel more than doubled the odds of having LVEF ≤35%.

Conclusions:

• An expanded panel of readily available ECG markers shows a strong correlation with severely reduced LVEF across different populations.
• This electrical surrogate score has the potential to facilitate the diagnosis of severely reduced LVEF.
• Prospective evaluation of this ECG marker-based diagnostic tool is warranted.