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Reproducibility of global electrical heterogeneity measurements on 12-lead ECG: The Multi-Ethnic Study of Atherosclerosis
Journal of Electrocardiology ( IF 1.3 ) Pub Date : 2021-10-02 , DOI: 10.1016/j.jelectrocard.2021.09.014
Kazi T Haq 1 , Katherine J Lutz 1 , Kyle K Peters 1 , Natalie E Craig 1 , Evan Mitchell 1 , Anish K Desai 1 , Nathan W L Stencel 1 , Elsayed Z Soliman 2 , João A C Lima 3 , Larisa G Tereshchenko 4
Affiliation  

Objective

Vectorcardiographic (VCG) global electrical heterogeneity (GEH) metrics showed clinical usefulness. We aimed to assess the reproducibility of GEH metrics.

Methods

GEH was measured on two 10-s 12‑lead ECGs recorded on the same day in 4316 participants of the Multi-Ethnic Study of Atherosclerosis (age 69.4 ± 9.4 y; 2317(54%) female, 1728 (40%) white, 1138(26%) African-American, 519(12%) Asian-American, 931(22%) Hispanic-American). GEH was measured on a median beat, comprised of the normal sinus (N), atrial fibrillation/flutter (S), and ventricular-paced (VP) beats. Spatial ventricular gradient's (SVG's) scalar was measured as sum absolute QRST integral (SAIQRST) and vector magnitude QT integral (VMQTi).

Results

Two N ECGs with heart rate (HR) bias of −0.64 (95% limits of agreement [LOA] -5.68 to 5.21) showed spatial area QRS-T angle (aQRST) bias of −0.12 (95%LOA −14.8 to 14.5). Two S ECGs with HR bias of 0.20 (95%LOA −15.8 to 16.2) showed aQRST bias of 1.37 (95%LOA −33.2 to 35.9). Two VP ECGs with HR bias of 0.25 (95%LOA −3.0 to 3.5) showed aQRST bias of −1.03 (95%LOA −11.9 to 9.9). After excluding premature atrial or ventricular beat and two additional beats (before and after extrasystole), the number of cardiac beats included in a median beat did not affect the GEH reproducibility. Mean-centered log-transformed values of SAIQRST and VMQTi demonstrated perfect agreement (Bias 0; 95%LOA −0.092 to 0.092).

Conclusion

GEH measurements on N, S, and VP median beats are reproducible. SVG's scalar can be measured as either SAIQRST or VMQTi.

Significance

Satisfactory reproducibility of GEH metrics supports their implementation.



中文翻译:


12 导联心电图整体电异质性测量的再现性:动脉粥样硬化的多种族研究


 客观的


心向量图 (VCG) 全局电异质性 (GEH) 指标显示出临床实用性。我们的目的是评估 GEH 指标的再现性。

 方法


GEH 是通过同一天记录的 4316 名动脉粥样硬化多种族研究参与者(年龄 69.4 ± 9.4 岁;2317(54%)名女性、1728(40%)白人、1138 名参与者的两次 10 秒 12 导联心电图来测量的(26%) 非洲裔美国人,519(12%) 亚裔美国人,931(22%) 西班牙裔美国人)。 GEH 是根据中位心搏进行测量的,包括正常窦性 (N)、心房颤动/扑动 (S) 和心室起搏 (VP) 心搏。空间心室梯度 (SVG) 标量被测量为绝对 QRST 积分 (SAIQRST) 和矢量幅度 QT 积分 (VMQTi) 之和。

 结果


心率 (HR) 偏差为 -0.64(95% 一致性极限 [LOA] -5.68 至 5.21)的两个 N ECG 显示空间面积 QRS-T 角 (aQRST) 偏差为 -0.12(95% LOA -14.8 至 14.5) 。 HR 偏差为 0.20(95%LOA -15.8 至 16.2)的两个 S ECG 显示 QRST 偏差为 1.37(95%LOA -33.2 至 35.9)。 HR 偏差为 0.25(95%LOA -3.0 至 3.5)的两个 VP ECG 显示 QRST 偏差为 -1.03(95%LOA -11.9 至 9.9)。排除房性早搏或室性早搏以及两次额外搏动(期外收缩之前和之后)后,中位搏动中包含的心跳次数不会影响 GEH 的再现性。 SAIQRST 和 VMQTi 的以平均值为中心的对数转换值表现出完全一致(偏差 0;95%LOA -0.092 至 0.092)。

 结论


N、S 和 VP 中位心跳的 GEH 测量结果是可重复的。 SVG 的标量可以用 SAIQRST 或 VMQTi 来测量。

 意义


GEH 指标令人满意的再现性支持其实施。

更新日期:2021-10-07
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