Electrocardiographic Parameters Associated with Adverse Outcomes in Children with Cardiomyopathies

Area of Science:

• Pediatric Cardiology
• Cardiovascular Electrophysiology
• Biomarker Research

Background:

• Cardiomyopathies in children are rare but can lead to severe outcomes like arrhythmias and heart failure.
• The QRS-T angle, an electrocardiogram (ECG) parameter, is linked to adverse events in adult cardiomyopathies.
• Identifying risk factors for adverse cardiac events in pediatric cardiomyopathies is crucial.

Purpose of the Study:

• To evaluate electrocardiographic parameters, specifically the QRS-T angle, associated with adverse cardiac events in children with cardiomyopathies.
• To determine the predictive value of the QRS-T angle and serum biomarkers for unfavorable outcomes in pediatric cardiomyopathy patients.

Main Methods:

• A study included 42 children with cardiomyopathies (dilated, hypertrophic, left ventricular non-compaction) and 19 controls.
• Electrocardiographic parameters, including the QRS-T angle, were analyzed.
• Serum levels of NT-proBNP and troponin I were measured; clinical severity was assessed using NYHA or Ross scales.

Main Results:

• The QRS-T angle was significantly larger in pediatric cardiomyopathy patients with adverse outcomes (133°) compared to those without (65°).
• Kaplan-Meier survival analysis revealed that a QRS-T angle > 120°, elevated NT-proBNP, elevated troponin I, and higher NYHA/Ross scores were associated with increased risk.
• NT-proBNP (p = 0.003) and troponin (p < 0.001) levels also correlated with poorer survival.

Conclusions:

• The QRS-T angle is a valuable ECG metric for identifying children with cardiomyopathies at high cardiovascular risk.
• Serum biomarkers NT-proBNP and troponin are useful for assessing survival prognosis in pediatric cardiomyopathy.
• Combining ECG parameters like the QRS-T angle with biomarkers can enhance risk stratification in pediatric cardiomyopathies.