The diagnostic capability of electrocardiography on the cardiogenic shock in the patients with acute myocarditis
- PDF / 1,127,151 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 71 Downloads / 177 Views
Open Access
RESEARCH ARTICLE
The diagnostic capability of electrocardiography on the cardiogenic shock in the patients with acute myocarditis Dan Yang1†, Qing Dai1†, Han Wu1†, Jianzhou Chen1, Jingmei Zhang1,2* and Zhonghai Wei1*
Abstract Background: The study was performed to assess the diagnostic capability of ECG on the cardiogenic shock (CS) in acute myocarditis. A new score was derived from the combination of the ECG parameters and the diagnostic value was also evaluated. Methods: Total 103 consecutive patients with acute myocarditis admitted in Nanjing Drum Hospital were enrolled in the current study. The cohort was divided into fulminant myocarditis group (FM, n = 20) and non fulminant myocarditis group (NFM, n = 83). The demographic features, results of electrocardiography (ECG) and ultracardiography were compared. Logistic regression analysis was conducted to identify the relevant factors in ECG parameters. We created a new variable called “ECG score” by certain combination of ECG parameters. The diagnostic capability of ECG score for CS was compared with the existing diagnostic indices using regression model and receiver-operating characteristics (ROC) analysis. Results: There were several changes on ECG significantly different between the two groups. Multivariate regression analysis demonstrated PR + QRS interval (P = 0.008), ventricular arrhythmia (P = 0.001) and pathological Q wave (P = 0.003) were the independent relevant factors of CS. The derived variable “ECG score” was identified as a significant relevant factor of CS by multivariate regression model. ROC analysis showed PR + QRS interval, ventricular arrhythmia and pathological Q wave all had equivalent diagnostic capability to left ventricular ejection fraction (LVEF) and shock index (SI). ECG score was equivalent to LVEF but superior to SI in diagnosing CS Conclusions: ECG was valuable in diagnosing CS due to acute myocarditis. The ECG score was superior to the traditional diagnostic indices and could be used for an rapid recognition of CS. Keywords: Fulminant myocarditis, Cardiogenic shock, Electrocardiography, Diagnosis Background Myocarditis is a inflammatory disease involving injury of the cardiac myocytes, the incidence of which is estimated approximate 0.02–0.1% in the general population *Correspondence: [email protected]; [email protected] † Dan Yang, Qing Dai and Han Wu have contributed equally to this manuscript 1 Department of Cardiology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, China Full list of author information is available at the end of the article
[1, 2]. Fulminant myocarditis (FM), the most severe type, is characterized with cardiogenic shock (CS) and haemodynamical disorder. It usually undergoes a fatal course and some of the cases probably come to a frustrating end. On the contrary, nonfulminant myocarditis (NFM) often produces symptoms of heart failure with stable haemodynamical status [3]. Of note, NFM could sometimes evolve into FM very quickly after first medical contact (FMC).
Data Loading...
