Electrical surrogate for detection of severe left ventricular systolic dysfunction

Kyndaron Reinier, Aapo L. Aro, Audrey Uy-Evanado, Carmen Rusinaru, Harpriya S. Chugh, Takahiro Shiota, Jonathan Jui, Sumeet S. Chugh

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Early diagnosis and therapy improves outcomes in heart failure with severely reduced left ventricular ejection fraction (LVEF ≤35%), but some patients may remain undiagnosed. We hypothesized that a combination of electrocardiogram (ECG) markers may identify individuals with severely reduced LVEF. Methods: From a community-based study in the Northwest US (the Oregon Sudden Unexpected Death Study), we evaluated the prevalence of conventional ECG markers by LVEF. We then evaluated the association of nine additional ECG markers and LVEF. We validated the correlation of these ECG markers and LVEF in a separate, large health system in Los Angeles, California. Results: In the discovery population (n = 1,047), patients with LVEF ≤35% were twice as likely as those with LVEF >35% to have ≥1 conventional ECG abnormality. In the subset without conventional ECG abnormalities, ≥4 abnormal ECG markers from the expanded panel were found in 12% vs. 1% of patients with LVEF ≤35% and >35%, respectively. In the validation population (n = 9,742), 44% with LVEF ≤35% and 17% with LVEF >35% had ≥1 conventional ECG abnormality. In patients without conventional ECG abnormalities (n = 7,601), 40% with LVEF ≤35% and 5% with LVEF >35% had ≥4 abnormal ECG markers from the expanded panel. Each additional abnormal ECG marker from the expanded panel (range 0 to ≥4) more than doubled the odds of LVEF ≤35%. Conclusions: An expanded panel of easily obtained ECG markers correlated strongly with severely reduced LVEF in two separate populations. This electrical surrogate score could facilitate diagnosis of severely reduced LVEF, and warrants prospective evaluation.

Original languageEnglish (US)
Article numbere12591
JournalAnnals of Noninvasive Electrocardiology
Volume23
Issue number6
DOIs
StatePublished - Nov 1 2018

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Left Ventricular Dysfunction
Electrocardiography
Northwestern United States
Population
Los Angeles
Sudden Death
Secondary Prevention
Stroke Volume
Early Diagnosis
Heart Failure
Cross-Sectional Studies

Keywords

  • cardiomyopathy
  • echocardiography
  • electrocardiography
  • heart failure
  • left ventricular ejection fraction
  • left ventricular systolic dysfunction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Reinier, K., Aro, A. L., Uy-Evanado, A., Rusinaru, C., Chugh, H. S., Shiota, T., ... Chugh, S. S. (2018). Electrical surrogate for detection of severe left ventricular systolic dysfunction. Annals of Noninvasive Electrocardiology, 23(6), [e12591]. https://doi.org/10.1111/anec.12591

Electrical surrogate for detection of severe left ventricular systolic dysfunction. / Reinier, Kyndaron; Aro, Aapo L.; Uy-Evanado, Audrey; Rusinaru, Carmen; Chugh, Harpriya S.; Shiota, Takahiro; Jui, Jonathan; Chugh, Sumeet S.

In: Annals of Noninvasive Electrocardiology, Vol. 23, No. 6, e12591, 01.11.2018.

Research output: Contribution to journalArticle

Reinier, K, Aro, AL, Uy-Evanado, A, Rusinaru, C, Chugh, HS, Shiota, T, Jui, J & Chugh, SS 2018, 'Electrical surrogate for detection of severe left ventricular systolic dysfunction', Annals of Noninvasive Electrocardiology, vol. 23, no. 6, e12591. https://doi.org/10.1111/anec.12591
Reinier, Kyndaron ; Aro, Aapo L. ; Uy-Evanado, Audrey ; Rusinaru, Carmen ; Chugh, Harpriya S. ; Shiota, Takahiro ; Jui, Jonathan ; Chugh, Sumeet S. / Electrical surrogate for detection of severe left ventricular systolic dysfunction. In: Annals of Noninvasive Electrocardiology. 2018 ; Vol. 23, No. 6.
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abstract = "Background: Early diagnosis and therapy improves outcomes in heart failure with severely reduced left ventricular ejection fraction (LVEF ≤35{\%}), but some patients may remain undiagnosed. We hypothesized that a combination of electrocardiogram (ECG) markers may identify individuals with severely reduced LVEF. Methods: From a community-based study in the Northwest US (the Oregon Sudden Unexpected Death Study), we evaluated the prevalence of conventional ECG markers by LVEF. We then evaluated the association of nine additional ECG markers and LVEF. We validated the correlation of these ECG markers and LVEF in a separate, large health system in Los Angeles, California. Results: In the discovery population (n = 1,047), patients with LVEF ≤35{\%} were twice as likely as those with LVEF >35{\%} to have ≥1 conventional ECG abnormality. In the subset without conventional ECG abnormalities, ≥4 abnormal ECG markers from the expanded panel were found in 12{\%} vs. 1{\%} of patients with LVEF ≤35{\%} and >35{\%}, respectively. In the validation population (n = 9,742), 44{\%} with LVEF ≤35{\%} and 17{\%} with LVEF >35{\%} had ≥1 conventional ECG abnormality. In patients without conventional ECG abnormalities (n = 7,601), 40{\%} with LVEF ≤35{\%} and 5{\%} with LVEF >35{\%} had ≥4 abnormal ECG markers from the expanded panel. Each additional abnormal ECG marker from the expanded panel (range 0 to ≥4) more than doubled the odds of LVEF ≤35{\%}. Conclusions: An expanded panel of easily obtained ECG markers correlated strongly with severely reduced LVEF in two separate populations. This electrical surrogate score could facilitate diagnosis of severely reduced LVEF, and warrants prospective evaluation.",
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AU - Reinier, Kyndaron

AU - Aro, Aapo L.

AU - Uy-Evanado, Audrey

AU - Rusinaru, Carmen

AU - Chugh, Harpriya S.

AU - Shiota, Takahiro

AU - Jui, Jonathan

AU - Chugh, Sumeet S.

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N2 - Background: Early diagnosis and therapy improves outcomes in heart failure with severely reduced left ventricular ejection fraction (LVEF ≤35%), but some patients may remain undiagnosed. We hypothesized that a combination of electrocardiogram (ECG) markers may identify individuals with severely reduced LVEF. Methods: From a community-based study in the Northwest US (the Oregon Sudden Unexpected Death Study), we evaluated the prevalence of conventional ECG markers by LVEF. We then evaluated the association of nine additional ECG markers and LVEF. We validated the correlation of these ECG markers and LVEF in a separate, large health system in Los Angeles, California. Results: In the discovery population (n = 1,047), patients with LVEF ≤35% were twice as likely as those with LVEF >35% to have ≥1 conventional ECG abnormality. In the subset without conventional ECG abnormalities, ≥4 abnormal ECG markers from the expanded panel were found in 12% vs. 1% of patients with LVEF ≤35% and >35%, respectively. In the validation population (n = 9,742), 44% with LVEF ≤35% and 17% with LVEF >35% had ≥1 conventional ECG abnormality. In patients without conventional ECG abnormalities (n = 7,601), 40% with LVEF ≤35% and 5% with LVEF >35% had ≥4 abnormal ECG markers from the expanded panel. Each additional abnormal ECG marker from the expanded panel (range 0 to ≥4) more than doubled the odds of LVEF ≤35%. Conclusions: An expanded panel of easily obtained ECG markers correlated strongly with severely reduced LVEF in two separate populations. This electrical surrogate score could facilitate diagnosis of severely reduced LVEF, and warrants prospective evaluation.

AB - Background: Early diagnosis and therapy improves outcomes in heart failure with severely reduced left ventricular ejection fraction (LVEF ≤35%), but some patients may remain undiagnosed. We hypothesized that a combination of electrocardiogram (ECG) markers may identify individuals with severely reduced LVEF. Methods: From a community-based study in the Northwest US (the Oregon Sudden Unexpected Death Study), we evaluated the prevalence of conventional ECG markers by LVEF. We then evaluated the association of nine additional ECG markers and LVEF. We validated the correlation of these ECG markers and LVEF in a separate, large health system in Los Angeles, California. Results: In the discovery population (n = 1,047), patients with LVEF ≤35% were twice as likely as those with LVEF >35% to have ≥1 conventional ECG abnormality. In the subset without conventional ECG abnormalities, ≥4 abnormal ECG markers from the expanded panel were found in 12% vs. 1% of patients with LVEF ≤35% and >35%, respectively. In the validation population (n = 9,742), 44% with LVEF ≤35% and 17% with LVEF >35% had ≥1 conventional ECG abnormality. In patients without conventional ECG abnormalities (n = 7,601), 40% with LVEF ≤35% and 5% with LVEF >35% had ≥4 abnormal ECG markers from the expanded panel. Each additional abnormal ECG marker from the expanded panel (range 0 to ≥4) more than doubled the odds of LVEF ≤35%. Conclusions: An expanded panel of easily obtained ECG markers correlated strongly with severely reduced LVEF in two separate populations. This electrical surrogate score could facilitate diagnosis of severely reduced LVEF, and warrants prospective evaluation.

KW - cardiomyopathy

KW - echocardiography

KW - electrocardiography

KW - heart failure

KW - left ventricular ejection fraction

KW - left ventricular systolic dysfunction

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