liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
Electrocardiographic amplitudes: a new risk factor for sudden death in hypertrophic cardiomyopathy
Gothenburg University.
Sunderby Hospital.
Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
Gothenburg University.
Show others and affiliations
2010 (English)In: EUROPEAN HEART JOURNAL, ISSN 0195-668X, Vol. 31, no 4, 439-449 p.Article in journal (Refereed) Published
Abstract [en]

Assessment of ECG-features as predictors of sudden death in adults with hypertrophic cardiomyopathy (HCM). ECG-amplitude sums were measured in 44 normals, 34 athletes, a hospital-cohort of 87 HCM-patients, and 29 HCM-patients with sudden death or cardiac arrest (HCM-CA). HCM-patients with sudden death or cardiac arrest had substantially higher ECG-amplitudes than the HCM-cohort for limb-lead and 12-lead QRS-amplitude sums, and amplitude-duration products (P = 0.00003-P = 0.000002). Separation of HCM-CA from the HCM-cohort is obtained by limb-lead QRS-amplitude sum andgt;= 7.7 mV (odds ratio 18.8, sensitivity 87%, negative predictive value (NPV) 94%, P andlt; 0.0001), 12-lead amplitude-duration product andgt;= 2.2 mV s (odds ratio 31.0, sensitivity 92%, NPV 97%, P andlt; 0.0001), and limb-lead amplitude-duration product andgt;= 0.70 mV s (odds ratio 31.5, sensitivity 93%, NPV 96%, P andlt; 0.0001). Sensitivity in HCM-patients andlt; 40 years is 90, 100, and 100% for those ECG-variables, respectively. Qualitative analysis showed correlation with cardiac arrest for pathological T-wave-inversion (P = 0.0003), ST-depression (P = 0.0010), and dominant S-wave in V-4 (P = 0.0048). A risk score is proposed; a score andgt;= 6 gives a sensitivity of 85% but a higher positive predictive value than above measures. Optimal separation between HCM-CA andlt; 40 years and athletes is obtained by a risk score andgt;= 6 (odds ratio 345, sensitivity 85%, specificity 100%, P andlt; 0.0001). Twelve-lead ECG is a powerful instrument for risk-stratification in HCM.

Place, publisher, year, edition, pages
2010. Vol. 31, no 4, 439-449 p.
Keyword [en]
Hypertrophic cardiomyopathy, Sudden death, Electrocardiogram, Screening, Athletes, Gender
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-54261DOI: 10.1093/eurheartj/ehp443ISI: 000274787100012OAI: diva2:302284
Available from: 2010-03-05 Created: 2010-03-05 Last updated: 2010-03-05

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Nylander, Eva
By organisation
Clinical Physiology Faculty of Health SciencesDepartment of Clinical Physiology
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 44 hits
ReferencesLink to record
Permanent link

Direct link