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Dispersion of ventricular repolarization in hypertrophic cardiomyopathy
1Division of Cardiology, Cliniques Universitaires Saint Luc, Brussels, Belgium.
Insights
Dispersion of ventricular repolarization (DVR) indices are significantly elevated in hypertrophic cardiomyopathy patients. This finding aids in differentiating HCM from other conditions using electrocardiogram data.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Diagnostics
Background:
- Dispersion of ventricular repolarization (DVR) is a critical electrophysiological parameter.
- Assessing DVR aids in understanding cardiac conditions and risks.
- Standard electrocardiogram (ECG) interpretation may not fully capture subtle repolarization abnormalities.
Purpose of the Study:
- To automatically compute and evaluate four electrocardiographic indices of DVR.
- To compare DVR values between healthy subjects, patients with left ventricular hypertrophy (LVH), and patients with hypertrophic cardiomyopathy (HCM).
- To determine if DVR indices can differentiate HCM from LVH and control groups.
Main Methods:
- Utilized a 15-lead electrocardiogram (ECG) record for averaged QRS-T cycle analysis.
- Employed interactive editing for precise computation of DVR indices.
- Quantified maximal interlead differences in QT and JT intervals (QT/JT apex and end).
- Compared DVR indices across three matched groups: control, LVH, and HCM.
Main Results:
- All four computed DVR indices were significantly increased in the HCM group compared to both control and LVH groups.
- The QTe dispersion index showed significantly higher mean values (65 ± 18 ms) and 97.5th percentiles (97 ms) in HCM patients.
- Maximal QT interval was significantly prolonged in the HCM group (464 ± 30 ms) versus LVH (436 ± 32 ms) and control (428 ± 25 ms) groups.
Conclusions:
- Elevated dispersion of ventricular repolarization indices are characteristic of hypertrophic cardiomyopathy.
- These DVR indices show potential as biomarkers for distinguishing HCM from LVH and healthy individuals.
- Automated ECG analysis of DVR offers a valuable tool for cardiac diagnostics.
Abstract:
On an averaged QRS-T cycle from a 15-lead record (12-lead electrocardiogram + XYZ leads) and through interactive editing, four electrocardiographic indices of the dispersion of ventricular repolarization (DVR) are automatically computed and represent the maximal interlead difference of QT and JTend and QT and JTapex. The values of these indices were then examined in three clinical groups matched for age and sex: normal subjects (control), patients with left ventricular hypertrophy (LVH group), and patients with hypertrophic cardiomyopathy (HCM group) without ventricular arrhythmias and without interacting drugs. The mean values of all four DVR indices were significantly increased in the HCM group compared with the control group and the LVH group of another origin (ie, for the QTe dispersion index, the mean values and the 97.5th percentiles were, respectively, 65 +/- 18 ms and 97 ms in the HCM group, 41 +/- 25 ms and 79 ms in the LVH group, and 31 +/- 15 ms and 58 ms in the control group). The maximal QT interval was also significantly longer in the HCM group (464 +/- 30 ms) than in the LVH group (436 +/- 32 ms) and the control group (428 +/- 25 ms).