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Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery
Published on: February 20, 2017
[Left arterial overload. Electro-echocardiographic correlations]
N R Koehler1, F J Velho, I C Collar
1Hospital São Lucas, Porto Alegre, RS.
Insights
Electrocardiography (ECG) shows limited accuracy in diagnosing left atrial enlargement (LAE). Atrial fibrillation and specific P wave changes in V1 demonstrated the highest correlation with echocardiographic findings for LAE.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Electrocardiography
Background:
- Left atrial enlargement (LAE) is a significant indicator of cardiovascular disease.
- Accurate diagnosis of LAE is crucial for risk stratification and management.
- M-mode echocardiography is the established gold standard for LAE assessment.
Purpose of the Study:
- To evaluate the diagnostic accuracy of various electrocardiographic (ECG) criteria for detecting left atrial enlargement (LAE).
- To compare ECG-based LAE diagnosis with M-mode echocardiography findings.
Main Methods:
- A study of 273 patients (age 17-87) with diverse cardiac conditions.
- Evaluation of specific ECG criteria: P terminal force in V1, P wave duration and notching in D2, and presence of atrial fibrillation.
- M-mode echocardiography was used as the gold standard to measure left atrial dimension (>40 mm).
Main Results:
- Atrial fibrillation showed the highest diagnostic accuracy (88%) for LAE.
- Other ECG criteria, including Morris index (75%) and P terminal force in V1 (74%), demonstrated moderate accuracy.
- P wave duration in D2 had the lowest accuracy (46%).
Conclusions:
- Conventional ECG criteria have limited sensitivity and specificity for diagnosing LAE.
- Atrial fibrillation and specific P wave abnormalities in lead V1 show a stronger correlation with echocardiographically determined LAE.
- Further research may refine ECG interpretation for improved LAE detection.
Purpose:
To compare the accuracy of left atrial enlargement (LAE) diagnosis made by electrocardiographic criteria with those obtained using M-mode echocardiography.
Methods:
We studied 273 patients age 17 to 87 (mean 49) years, 115 men, white 95.5%, black 3.5% mulattos 1%, with or without heart disease of different etiologies. The ECG criteria studied were: a) P terminal force in V1 > or = 0.04 mmx s; b) Pt force in V1 duration > 0.04s; c) Pt force in V1 depth > or = 1 mm; d) P wave notching in D2 with interpeak distance > or = 40ms; f) presence of atrial fibrillation. The gold-standard for LAE was left atrial dimension > 40 mm obtained by echocardiography.
Results:
The percentage of correct diagnosis were: atrial fibrillation (88%), Morris index (75%), PtfV1 negativity > or = 1 mm (74%), notched P wave in D2 with interpeak distance > or = 0.04 s (70%), PtfV1 with duration > 0.04 s (64%) and P wave duration in D2 > 0.11s (46%).
Conclusion:
Conventional ECG has limited value for detecting LAE. A higher correlation was found between atrial fibrillation and changes in P wave in V1 and the echocardiographic LAE.
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