Limb-lead amplitude-duration product ≥0.70 mV s strongly separated hypertrophic cardiomyopathy patients with sudden death or cardiac arrest from the general HCM cohort (OR 31.5; P<0.0001).
Case-Control (n=194)
Does 12-lead ECG amplitude assessment predict sudden death or cardiac arrest in patients with hypertrophic cardiomyopathy?
Twelve-lead ECG amplitude sums and amplitude-duration products are strong predictors of sudden death or cardiac arrest in patients with hypertrophic cardiomyopathy.
Effect estimate: OR 31.5
p-value: p=<0.0001
AIMS: Assessment of ECG-features as predictors of sudden death in adults with hypertrophic cardiomyopathy (HCM). METHODS AND RESULTS: ECG-amplitude sums were measured in 44 normals, 34 athletes, a hospital-cohort of 87 HCM-patients, and 29 HCM-patients with sudden death or cardiac arrest (HCM-CA). HCM-patients with sudden death or cardiac arrest had substantially higher ECG-amplitudes than the HCM-cohort for limb-lead and 12-lead QRS-amplitude sums, and amplitude-duration products (P = 0.00003-P = 0.000002). Separation of HCM-CA from the HCM-cohort is obtained by limb-lead QRS-amplitude sum >or=7.7 mV (odds ratio 18.8, sensitivity 87%, negative predictive value (NPV) 94%, P or=2.2 mV s (odds ratio 31.0, sensitivity 92%, NPV 97%, P or=0.70 mV s (odds ratio 31.5, sensitivity 93%, NPV 96%, P or=6 gives a sensitivity of 85% but a higher positive predictive value than above measures. Optimal separation between HCM-CA or=6 (odds ratio 345, sensitivity 85%, specificity 100%, P < 0.0001). CONCLUSION: Twelve-lead ECG is a powerful instrument for risk-stratification in HCM.
Östman‐Smith et al. (Thu,) conducted a case-control in Hypertrophic cardiomyopathy (HCM) (n=194). ECG-amplitude sums and amplitude-duration products vs. HCM-cohort without sudden death/cardiac arrest, normal controls, and athletes was evaluated on Sudden death or cardiac arrest (OR 31.5, p=<0.0001). Limb-lead amplitude-duration product ≥0.70 mV s strongly separated hypertrophic cardiomyopathy patients with sudden death or cardiac arrest from the general HCM cohort (OR 31.5; P<0.0001).