Accuracy of electrocardiographic criteria for atrial enlargement: validation with cardiovascular magnetic resonance
- PDF / 1,447,882 Bytes
- 7 Pages / 610 x 792 pts Page_size
- 24 Downloads / 189 Views
BioMed Central
Open Access
Research
Accuracy of electrocardiographic criteria for atrial enlargement: validation with cardiovascular magnetic resonance Connie W Tsao1, Mark E Josephson1, Thomas H Hauser1, T David O'Halloran1, Anupam Agarwal1,2, Warren J Manning1,3 and Susan B Yeon*1 Address: 1Harvard-Thorndike Laboratory and the Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, Massachusetts, USA, 2Cardiovascular and Metabolic Division, GlaxoSmithKline Pharmaceuticals, 1250 Collegeville Road, Collegeville, Pennsylvania, USA and 3Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, Massachusetts, USA Email: Connie W Tsao - [email protected]; Mark E Josephson - [email protected]; Thomas H Hauser - [email protected]; T David O'Halloran - [email protected]; Anupam Agarwal - [email protected]; Warren J Manning - [email protected]; Susan B Yeon* - [email protected] * Corresponding author
Published: 25 January 2008 Journal of Cardiovascular Magnetic Resonance 2008, 10:7
doi:10.1186/1532-429X-10-7
Received: 18 December 2007 Accepted: 25 January 2008
This article is available from: http://www.jcmr-online.com/content/10/1/7 © 2008 Tsao et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Anatomic atrial enlargement is associated with significant morbidity and mortality. However, atrial enlargement may not correlate with clinical measures such as electrocardiographic (ECG) criteria. Past studies correlating ECG criteria with anatomic measures mainly used inferior M-mode or two-dimensional echocardiographic data. We sought to determine the accuracy of the ECG to predict anatomic atrial enlargement as determined by volumetric cardiovascular magnetic resonance (CMR). Methods: ECG criteria for left (LAE) and right atrial enlargement (RAE) were compared to CMR atrial volume index measurements for 275 consecutive subjects referred for CMR (67% males, 51 ± 14 years). ECG criteria for LAE and RAE were assessed by an expert observer blinded to CMR data. Atrial volume index was computed using the biplane area-length method. Results: The prevalence of CMR LAE and RAE was 28% and 11%, respectively, and by any ECG criteria was 82% and 5%, respectively. Though nonspecific, the presence of at least one ECG criteria for LAE was 90% sensitive for CMR LAE. The individual criteria P mitrale, P wave axis < 30°, and negative P terminal force in V1 (NPTF-V1) > 0.04s·mm were 88–99% specific although not sensitive for CMR LAE. ECG was insensitive but 96–100% specific for CMR RAE. Conclusion: The presence of at least one ECG criteria for LAE is sensitive but
Data Loading...
