Using QRS loop descriptors to characterize the risk of sudden cardiac death in patients with structurally normal hearts

Cheng I. Wu; Yenn Jiang Lin; I. Hsin Lee; Men Tzung Lo; Yu Cheng Hsieh; Amelia Yun Yu Chen; Wei Kai Wang; Shih Lin Chang; Li Wei Lo; Yu Feng Hu; Fa Po Chung; Ta Chuan Tuan; Tze Fan Chao; Jo Nan Liao; Wan Hsin Hsieh; Ting Yung Chang; Chin Yu Lin; An Ning Feng; Chorng Kuang How; Shih Ann Chen

doi:10.1371/journal.pone.0263894

Using QRS loop descriptors to characterize the risk of sudden cardiac death in patients with structurally normal hearts

Cheng I. Wu, Yenn Jiang Lin, I. Hsin Lee, Men Tzung Lo, Yu Cheng Hsieh, Amelia Yun Yu Chen, Wei Kai Wang, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Fa Po Chung, Ta Chuan Tuan, Tze Fan Chao, Jo Nan Liao, Wan Hsin Hsieh, Ting Yung Chang, Chin Yu Lin, An Ning Feng, Chorng Kuang How, Shih Ann Chen

研究成果: 雜誌貢獻 › 期刊論文 › 同行評審

摘要

The predictive value of non-invasive electrocardiographic examination findings for the risk of sudden cardiac death (SCD) in populations with structurally normal hearts remains unclear. This study aimed to investigate the characteristics of the QRS vectorcardiography of surface electrocardiography in patients with structurally normal hearts who experienced SCD. We consecutively enrolled patients who underwent vectorcardiography between March 2017 and December 2018 in a tertiary referral medical center. These patients didn't have structural heart diseases, histories of congestive heart failure, or reduced ejection fraction, and they were classified into SCD (with aborted SCD history and cerebral performance category score of 1) and control groups (with an intervention for atrioventricular node reentrant tachycardia and without SCD history). A total of 162 patients (mean age, 54.3±18.1 years; men, 75.9%), including 59 in the SCD group and 103 in the control group, underwent propensity analysis. The baseline demographic variables, underlying diseases, QRS loop descriptors (the percentage of the loop area, loop dispersion, and inter-lead QRS dispersion), and other electrocardiographic parameters were compared between the two groups. In the univariate and multivariate analyses, a smaller percentage of the loop area (odds ratio, 0.0003; 95% confidence interval, 0.00-0.02; p<0.001), more significant V_4-5 dispersion (odds ratio, 1.04; 95% confidence interval, 1.02-1.07; p = 0.002), and longer QRS duration (odds ratio, 1.05; 95% confidence interval, 1.00-1.10; p = 0.04) were associated with SCD. In conclusion, the QRS loop descriptors of surface electrocardiography could be used as non-invasive markers to identify patients experiencing aborted SCD from a healthy population. A decreased percentage of loop area and elevated V_4-5 QRS dispersion values assessed using vectorcardiography were associated with an increased risk of SCD in patients with structurally normal hearts.

原文	???core.languages.en_GB???
文章編號	e0263894
期刊	PLoS ONE
卷	17
發行號	2 February
DOIs	https://doi.org/10.1371/journal.pone.0263894
出版狀態	已出版 - 2月 2022

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10.1371/journal.pone.0263894

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Wu, C. I., Lin, Y. J., Lee, I. H., Lo, M. T., Hsieh, Y. C., Chen, A. Y. Y., Wang, W. K., Chang, S. L., Lo, L. W., Hu, Y. F., Chung, F. P., Tuan, T. C., Chao, T. F., Liao, J. N., Hsieh, W. H., Chang, T. Y., Lin, C. Y., Feng, A. N., How, C. K., & Chen, S. A. (2022). Using QRS loop descriptors to characterize the risk of sudden cardiac death in patients with structurally normal hearts. PLoS ONE, 17(2 February), 文章 e0263894. https://doi.org/10.1371/journal.pone.0263894

@article{c389ac33705f43e2bcdf2641a7a6b9b7,

title = "Using QRS loop descriptors to characterize the risk of sudden cardiac death in patients with structurally normal hearts",

abstract = "The predictive value of non-invasive electrocardiographic examination findings for the risk of sudden cardiac death (SCD) in populations with structurally normal hearts remains unclear. This study aimed to investigate the characteristics of the QRS vectorcardiography of surface electrocardiography in patients with structurally normal hearts who experienced SCD. We consecutively enrolled patients who underwent vectorcardiography between March 2017 and December 2018 in a tertiary referral medical center. These patients didn't have structural heart diseases, histories of congestive heart failure, or reduced ejection fraction, and they were classified into SCD (with aborted SCD history and cerebral performance category score of 1) and control groups (with an intervention for atrioventricular node reentrant tachycardia and without SCD history). A total of 162 patients (mean age, 54.3±18.1 years; men, 75.9%), including 59 in the SCD group and 103 in the control group, underwent propensity analysis. The baseline demographic variables, underlying diseases, QRS loop descriptors (the percentage of the loop area, loop dispersion, and inter-lead QRS dispersion), and other electrocardiographic parameters were compared between the two groups. In the univariate and multivariate analyses, a smaller percentage of the loop area (odds ratio, 0.0003; 95% confidence interval, 0.00-0.02; p<0.001), more significant V4-5 dispersion (odds ratio, 1.04; 95% confidence interval, 1.02-1.07; p = 0.002), and longer QRS duration (odds ratio, 1.05; 95% confidence interval, 1.00-1.10; p = 0.04) were associated with SCD. In conclusion, the QRS loop descriptors of surface electrocardiography could be used as non-invasive markers to identify patients experiencing aborted SCD from a healthy population. A decreased percentage of loop area and elevated V4-5 QRS dispersion values assessed using vectorcardiography were associated with an increased risk of SCD in patients with structurally normal hearts.",

author = "Wu, {Cheng I.} and Lin, {Yenn Jiang} and Lee, {I. Hsin} and Lo, {Men Tzung} and Hsieh, {Yu Cheng} and Chen, {Amelia Yun Yu} and Wang, {Wei Kai} and Chang, {Shih Lin} and Lo, {Li Wei} and Hu, {Yu Feng} and Chung, {Fa Po} and Tuan, {Ta Chuan} and Chao, {Tze Fan} and Liao, {Jo Nan} and Hsieh, {Wan Hsin} and Chang, {Ting Yung} and Lin, {Chin Yu} and Feng, {An Ning} and How, {Chorng Kuang} and Chen, {Shih Ann}",

note = "Publisher Copyright: {\textcopyright} 2022 Wu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2022",

month = feb,

doi = "10.1371/journal.pone.0263894",

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volume = "17",

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Wu, CI, Lin, YJ, Lee, IH, Lo, MT, Hsieh, YC, Chen, AYY, Wang, WK, Chang, SL, Lo, LW, Hu, YF, Chung, FP, Tuan, TC, Chao, TF, Liao, JN, Hsieh, WH, Chang, TY, Lin, CY, Feng, AN, How, CK & Chen, SA 2022, 'Using QRS loop descriptors to characterize the risk of sudden cardiac death in patients with structurally normal hearts', PLoS ONE, 卷 17, 編號 2 February, e0263894. https://doi.org/10.1371/journal.pone.0263894

TY - JOUR

T1 - Using QRS loop descriptors to characterize the risk of sudden cardiac death in patients with structurally normal hearts

AU - Wu, Cheng I.

AU - Lin, Yenn Jiang

AU - Lee, I. Hsin

AU - Lo, Men Tzung

AU - Hsieh, Yu Cheng

AU - Chen, Amelia Yun Yu

AU - Wang, Wei Kai

AU - Chang, Shih Lin

AU - Lo, Li Wei

AU - Hu, Yu Feng

AU - Chung, Fa Po

AU - Tuan, Ta Chuan

AU - Chao, Tze Fan

AU - Liao, Jo Nan

AU - Hsieh, Wan Hsin

AU - Chang, Ting Yung

AU - Lin, Chin Yu

AU - Feng, An Ning

AU - How, Chorng Kuang

AU - Chen, Shih Ann

N1 - Publisher Copyright: © 2022 Wu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2022/2

Y1 - 2022/2

N2 - The predictive value of non-invasive electrocardiographic examination findings for the risk of sudden cardiac death (SCD) in populations with structurally normal hearts remains unclear. This study aimed to investigate the characteristics of the QRS vectorcardiography of surface electrocardiography in patients with structurally normal hearts who experienced SCD. We consecutively enrolled patients who underwent vectorcardiography between March 2017 and December 2018 in a tertiary referral medical center. These patients didn't have structural heart diseases, histories of congestive heart failure, or reduced ejection fraction, and they were classified into SCD (with aborted SCD history and cerebral performance category score of 1) and control groups (with an intervention for atrioventricular node reentrant tachycardia and without SCD history). A total of 162 patients (mean age, 54.3±18.1 years; men, 75.9%), including 59 in the SCD group and 103 in the control group, underwent propensity analysis. The baseline demographic variables, underlying diseases, QRS loop descriptors (the percentage of the loop area, loop dispersion, and inter-lead QRS dispersion), and other electrocardiographic parameters were compared between the two groups. In the univariate and multivariate analyses, a smaller percentage of the loop area (odds ratio, 0.0003; 95% confidence interval, 0.00-0.02; p<0.001), more significant V4-5 dispersion (odds ratio, 1.04; 95% confidence interval, 1.02-1.07; p = 0.002), and longer QRS duration (odds ratio, 1.05; 95% confidence interval, 1.00-1.10; p = 0.04) were associated with SCD. In conclusion, the QRS loop descriptors of surface electrocardiography could be used as non-invasive markers to identify patients experiencing aborted SCD from a healthy population. A decreased percentage of loop area and elevated V4-5 QRS dispersion values assessed using vectorcardiography were associated with an increased risk of SCD in patients with structurally normal hearts.

AB - The predictive value of non-invasive electrocardiographic examination findings for the risk of sudden cardiac death (SCD) in populations with structurally normal hearts remains unclear. This study aimed to investigate the characteristics of the QRS vectorcardiography of surface electrocardiography in patients with structurally normal hearts who experienced SCD. We consecutively enrolled patients who underwent vectorcardiography between March 2017 and December 2018 in a tertiary referral medical center. These patients didn't have structural heart diseases, histories of congestive heart failure, or reduced ejection fraction, and they were classified into SCD (with aborted SCD history and cerebral performance category score of 1) and control groups (with an intervention for atrioventricular node reentrant tachycardia and without SCD history). A total of 162 patients (mean age, 54.3±18.1 years; men, 75.9%), including 59 in the SCD group and 103 in the control group, underwent propensity analysis. The baseline demographic variables, underlying diseases, QRS loop descriptors (the percentage of the loop area, loop dispersion, and inter-lead QRS dispersion), and other electrocardiographic parameters were compared between the two groups. In the univariate and multivariate analyses, a smaller percentage of the loop area (odds ratio, 0.0003; 95% confidence interval, 0.00-0.02; p<0.001), more significant V4-5 dispersion (odds ratio, 1.04; 95% confidence interval, 1.02-1.07; p = 0.002), and longer QRS duration (odds ratio, 1.05; 95% confidence interval, 1.00-1.10; p = 0.04) were associated with SCD. In conclusion, the QRS loop descriptors of surface electrocardiography could be used as non-invasive markers to identify patients experiencing aborted SCD from a healthy population. A decreased percentage of loop area and elevated V4-5 QRS dispersion values assessed using vectorcardiography were associated with an increased risk of SCD in patients with structurally normal hearts.

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DO - 10.1371/journal.pone.0263894

M3 - 期刊論文

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SN - 1932-6203

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JO - PLoS ONE

JF - PLoS ONE

IS - 2 February

M1 - e0263894

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Using QRS loop descriptors to characterize the risk of sudden cardiac death in patients with structurally normal hearts

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