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Basic study for computer analysis of the pediatric electrocardiogram: relation of the distance-corrected precordial
Insights
Correcting precordial voltage (SV1 + RV5) by the square of distance (D) improved correlation with left ventricular muscle volume (LVMV) in children. This adjusted measure (D2 [SV1 + RV5]) showed better predictive value for LVMV.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Biomedical Engineering
Background:
- Assessing left ventricular muscle volume (LVMV) is crucial for pediatric cardiac health.
- Standard electrocardiogram (ECG) voltage measurements (SV1 + RV5) show poor correlation with LVMV in children.
- Chest wall thickness, specifically the distance (D) to the left ventricle, influences ECG signal strength.
Purpose of the Study:
- To investigate if correcting precordial voltage by chest wall distance improves its correlation with LVMV in children.
- To evaluate the effectiveness of an adjusted voltage measurement (D2 [SV1 + RV5]) for estimating LVMV.
- To explore sex-based differences in this adjusted measurement and identify contributing factors.
Main Methods:
- Echocardiography was used to measure LVMV and chest wall distance (D) in 476 children.
- Summed precordial voltage (SV1 + RV5) was recorded.
- A new metric, D2 (SV1 + RV5), was calculated by squaring the distance and multiplying by the voltage.
Main Results:
- Initial correlation between SV1 + RV5 and LVMV was poor (r=0.377 males, r=-0.095 females).
- The adjusted metric D2 (SV1 + RV5) showed significantly improved correlation with LVMV (r=0.712 males, r=0.469 females).
- Significant sex differences in D2 (SV1 + RV5) were observed in adolescents (12-16 years), potentially linked to subcutaneous fat.
Conclusions:
- Correcting precordial voltage by the square of chest wall distance enhances its utility for estimating LVMV in pediatric populations.
- The D2 (SV1 + RV5) metric offers a more reliable non-invasive assessment of LVMV compared to standard voltage measurements.
- Subcutaneous fat thickness may explain observed sex differences in the adjusted voltage-to-volume correlation.
Abstract:
The left ventricular muscle volume (LVMV) and the distance from the anterior chest wall to the middle of the left ventricle (D) were determined echocardiographically in 476 children as a part of the Shimane Heart Study. Correlation of the summed precordial voltage (SV1 + RV5) with LVMV was not good (r = 0.377 in males and -0.095 in females). The precordial voltage (SV1 + RV5), therefore, was corrected by the square of D to compensate the diminution of electrical potential by distance. Correlation between D2 (SV1 + RV5) and LVMV was good in males (r = 0.712) and relatively good in females (r = 0.469). Moreover, the values of D2 (SV1 + RV5) were different between both sexes at the age of 12--16 years. The thickness of subcutaneous fat may be one of the most important factors for these differences in D2 (SV1 + RV5) and correlation coefficient.