In patients with arrhythmogenic right-ventricular cardiomyopathy, right ventricular dilatation was significantly associated with lower total QRS amplitudes (RC -0.14) and precordial T-wave inversion.
Case-Control (n=84)
No
Are specific electrocardiographic characteristics (decreased QRS amplitudes and T-wave negativity) associated with right ventricular dilatation in patients with arrhythmogenic right-ventricular cardiomyopathy?
In patients with ARVC, decreased QRS amplitudes and extensive precordial T-wave inversion on a standard 12-lead ECG are significantly associated with right ventricular enlargement.
Effect estimate: RC -0.14 (95% CI -0.245 to -0.037)
p-value: p=0.009
BACKGROUND: Arrhythmogenic right-ventricular cardiomyopathy (ARVC) can lead to RV dilatation. We hypothesized that electrocardiographic characteristics including QRS amplitudes in the extremity- and precordial leads, the S amplitude in lead V1 , and extent of T-wave negativity over the precordial leads are related to RV dilatation in this condition. METHODS: In 42 ARVC patients and 42 controls, we correlated total QRS amplitude in the extremity leads (∑QRSext ), precordial leads (∑QRSprec ) and in all leads (∑QRStot : summation of ∑QRSext and ∑QRSprec ), S amplitude in lead V1 and the extent of T-wave inversion in the precordial leads (V1 vs. beyond V1 ) with RV end diastolic diameter (RVEDD) by echocardiography. RESULTS: In the ARVC group, the mean age was 46 ± 14 years, 31 patients were male, 28 had an implantable cardioverter defibrillator (ICD), and 7 had a LV ejection fraction (EF) < 55%. The control group was age- and gender matched to the ARVC cohort. In contrast to controls, the ∑QRSext (regression coefficient (RC), -0.29; P = 0.020), ∑QRSprec (RC, -0.20; P = 0.015), and ∑QRStot (RC, -0.14; P = 0.009) were lower with RV dilatation in ARVC. S amplitude in lead V1 was not related to RV diameter (RC, -0.98; P = 0.088). Precordial T-wave inversion beyond lead V1 (V2 -V6 ) was associated with a larger RV diameter (RC, 8.58; P = 0.012). CONCLUSIONS: Summed QRS amplitudes in the extremity and precordial leads, and T-wave inversion beyond lead V1 are associated with RV dilatation in patients with ARVC.
Zusterzeel et al. (Mon,) conducted a case-control in Arrhythmogenic right-ventricular cardiomyopathy (ARVC) (n=84). Arrhythmogenic right-ventricular cardiomyopathy (ARVC) vs. Healthy controls was evaluated on Correlation of total QRS amplitude (∑QRStot) with right-ventricular end-diastolic diameter (RVEDD) (RC -0.14, 95% CI -0.245 to -0.037, p=0.009). In patients with arrhythmogenic right-ventricular cardiomyopathy, right ventricular dilatation was significantly associated with lower total QRS amplitudes (RC -0.14) and precordial T-wave inversion.