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[Functional content of the electrocardiogram of coronary patients]
Insights
Electrocardiogram (ECG) R-wave amplitude effectively correlates with left ventricular function (LVF) in coronary artery disease patients without infarction. This ECG measure offers valuable insights into cardiac performance, aiding in non-invasive assessment.
Area of Science:
- Cardiology
- Biomedical Engineering
- Clinical Electrophysiology
Context:
- 180 coronary artery disease patients underwent catheterization and coronary angiography for angina.
- Patients were categorized into three groups: no significant stenosis, stenosis >50%, and myocardial infarction (>80% stenosis).
- Left ventricular function (LVF) parameters including ejection fraction (EF), systolic work (LVESW), and end-diastolic pressure (LVEDP) were analyzed.
Purpose:
- To compare hemodynamic and electrocardiographic data in coronary patients.
- To investigate the correlation between electrocardiogram (ECG) parameters and left ventricular function (LVF).
- To identify specific ECG variables related to LVF, particularly in patients without infarction.
Summary:
- A significant correlation was observed between the sum of R waves (sigma R) and EF (r=0.45, p<0.001).
- Sigma R was the sole ECG variable linked to LVF in patients without infarction, correlating with LVEDV, LVM, and LVESW.
- A discordance was noted between angiographically measured myocardial mass (LVM) and electrically active myocardium in infarction patients, with sigma R being independent of LVM, LVEDV, and LVESW in this subgroup.
Impact:
- The sum of R waves (sigma R) demonstrates potential as a non-invasive indicator of LVF in patients with coronary artery disease.
- Findings suggest sigma R can provide valuable insights into cardiac mechanics, especially in the absence of myocardial infarction.
- Highlights the utility of specific ECG parameters in assessing cardiac function and guiding clinical evaluation.
Abstract:
A comparison of the haemodynamic and electrocardiographic data was carried out in 180 coronary patients. All underwent catheterisation and coronary angiography for angina. They were divided into three main groups: 53 patients with coronary atheroma without significant stenosis; 43 patients with at least one coronary stenosis greater than 50%; 84 patients had myocardial infarction with ECG changes of transmural necrosis and coronary thrombosis (or greater than 80% stenosis). Parameters of left ventricular function (LVF), especially ejection fraction (EF), systolic work (LVESW), end diastolic pressure (LVEDP), end diastolic volume (LVEDV), myocardial mass calculated from angiography (LMV) and volumic compliance were analysed in all cases. Each patient had at least 5 ECG recordings analysed by a HP 6 calculator which determined the values of the principal numeric ECG parameters and the means of the 5 recordings. Particular attention was given to the sum of the R waves in the 12 leads (sigma R mV) and Macruz's index (duration of P/PR - P in Lead II). A satisfactory correlation was found overall between sigma R and EF (r = 0,45, p less than 0,001). sigma R was the only ECG variable related to LVF in patients without infarction. In this group of 96 patients, sigma R correlated with LVEDV (r = 0,46, p less than 0,001) with LVM (r = 0,46, p less than 0,001), with LVESW (r = 0,52, p less than 0,001). There was a discordance between angiographically measured LVM and the mass of electrically active myocardium in patients with infarction. sigma R was independent of LVM, LVEDV, and LVESW.(ABSTRACT TRUNCATED AT 250 WORDS)