TY - JOUR
T1 - Vectorcardiography as a prognostic tool in hypertrophic cardiomyopathy
AU - Jimenez, Erick
AU - El-Bokl, Amr
AU - Cortez, Daniel
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/8/16
Y1 - 2021/8/16
N2 - Background: Vectorcardiography (VCG) has demonstrated diagnostic value in the assessment of hypertrophic cardiomyopathy (HCM), however, determining its prognostic value over time has not yet been investigated. This study sought to assess the correlation of VCG parameters with the progression of HCM. Methods: A retrospective chart review of 119 pediatric patients with diagnosis of HCM at the University of Minnesota. Eighty-three cases were excluded because of age, presence of congenital heart disease, not meeting criteria for HCM or negative phenotype. Sample was divided into 2 groups based on the presence or not of cardiac events (ventricular tachycardia, cardiac arrest, ventricular assist device, heart transplant). Derived vectorcardiography from standard 12‑lead ECG was obtained for the first ECG and last available or prior to sentinel event. Results: Of the 36 cases that met inclusion criteria, 9 (25%) developed a sentinel event. The median age for the event group was 10.1 ± 7.5 years and for the non-event group was 8.7 ± 6.35 years. There was no significant difference in age or sex between the groups. The T wave vector magnitude value was significantly smaller in the event group than in the non-event group (0.302 ± 0.146 mV Vs. 0.561 ± 0.305 mV, p 0.002), with a hazard ratio of 0.651 (95% CI 0.463 to 0.915). No other parameter showed significant difference between the two groups. Conclusions: The T wave vector magnitude may predict sentinel events in HCM. Prospective studies are necessary to evaluate the utility of the evolution of VCG parameters.
AB - Background: Vectorcardiography (VCG) has demonstrated diagnostic value in the assessment of hypertrophic cardiomyopathy (HCM), however, determining its prognostic value over time has not yet been investigated. This study sought to assess the correlation of VCG parameters with the progression of HCM. Methods: A retrospective chart review of 119 pediatric patients with diagnosis of HCM at the University of Minnesota. Eighty-three cases were excluded because of age, presence of congenital heart disease, not meeting criteria for HCM or negative phenotype. Sample was divided into 2 groups based on the presence or not of cardiac events (ventricular tachycardia, cardiac arrest, ventricular assist device, heart transplant). Derived vectorcardiography from standard 12‑lead ECG was obtained for the first ECG and last available or prior to sentinel event. Results: Of the 36 cases that met inclusion criteria, 9 (25%) developed a sentinel event. The median age for the event group was 10.1 ± 7.5 years and for the non-event group was 8.7 ± 6.35 years. There was no significant difference in age or sex between the groups. The T wave vector magnitude value was significantly smaller in the event group than in the non-event group (0.302 ± 0.146 mV Vs. 0.561 ± 0.305 mV, p 0.002), with a hazard ratio of 0.651 (95% CI 0.463 to 0.915). No other parameter showed significant difference between the two groups. Conclusions: The T wave vector magnitude may predict sentinel events in HCM. Prospective studies are necessary to evaluate the utility of the evolution of VCG parameters.
KW - Electrocardiogram
KW - Hypertrophic cardiomyopathy
KW - Risk stratification
KW - Sudden cardiac death
KW - Vectorcardiography
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U2 - 10.1016/j.jelectrocard.2021.08.004
DO - 10.1016/j.jelectrocard.2021.08.004
M3 - Article
C2 - 34392139
AN - SCOPUS:85112431659
SN - 0022-0736
VL - 68
SP - 80
EP - 84
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
ER -