Presence Of Electrocardiographic Abnormalities Research Articles

Association of minor electrocardiographic (ECG) abnormalities with epilepsy duration in children: A manifestation of the epileptic heart?

PurposeCardiac abnormalities resulting from chronic epilepsy (“the epileptic heart”) constitute a well-recognized comorbidity. However, the association of cardiac alterations with epilepsy duration remains understudied. We sought to evaluate this association using electrocardiogram (ECG). MethodsWe prospectively enrolled children between 1 months and 18 years of age without known cardiac conditions or ion channelopathies during routine clinic visits. ECGs were categorized as abnormal if there were alterations in rhythm; PR, QRS, or corrected QT interval; QRS axis or morphology; ST segment or T wave. An independent association between ECG abnormalities and epilepsy duration was evaluated using multivariable logistic regression modeling. Results213 children were enrolled. 100 ECGs (47%) exhibited at least one alteration; most commonly in the ST segment (37, 17%) and T wave (29, 11%). Children with normal ECGs had shorter epilepsy duration as compared to those with ECG abnormalities (46 [18–91] months vs. 73 [32–128 months], p = 0.004). A multivariable logistic regression model demonstrated that increasing epilepsy duration was independently associated with the presence of ECG abnormalities (OR=1.09, 95% CI=1.02–1.16, p = 0.008), adjusted for seizure frequency, generalized tonic-clonic/focal to bilateral tonic-clonic seizures as the predominant seizure type, and number of channel-modifying anti-seizure medications. Increasing epilepsy duration was also independently associated with the presence of ST/T wave abnormalities (OR=1.09, 95% CI=1.01–1.16, p = 0.017), adjusted for the same covariates. SignificanceIncreasing epilepsy duration is independently associated with the presence of minor ECG abnormalities. Additional studies are needed to evaluate whether this finding may represent a manifestation of the “epileptic heart”.

The impact of chronic exposure to air pollution on electrocardiographic parameters.

Chronic exposure to air pollution caused by particulate matter (PM) with aerodynamic diameters of <10 μm (PM10) and <2.5 μm (PM2.5), dependent on "low emissions" resulting from the combustion of solid fuels in households, significantly increases the risk of cardiovascular events. The aim of the study was to assess the impact of chronic exposure to air pollution in the place of residence on the occurrence of coronary artery disease, hypertension and the presence of electrocardiographic abnormalities in 24-hour Holter ECG recording. After considering the exclusion criteria, 100 consecutive patients of the cardiology outpatient clinic were enrolled in the study, including 50 patients living for ≥10 years in Warsaw districts with the lowest average concentrations of PM2.5 (group I) and 50 living in the districts with the highest recorded exposure (group II). All patients underwent clinical and physical examination, 12-lead ECG, 2D cardiac echo, and Holter ECG. To avoid the impact of acute exposure, the study was carried out in May - the month with statistically the lowest recorded PM2.5 concentrations. In the group of patients exposed to higher concentrations of PM2.5 in the place of residence, coronary artery disease and arterial hypertension were significantly more frequent, while in the Holter ECG examination, ventricular arrhythmias, conduction disturbances and ST-segment and T-wave changes were independently associated with exposure to air pollution. Chronic exposure to air pollution in the place of residence contributes to the occurrence of chronic coronary syndrome and hypertension. Chronic exposure to air pollution seems to be a significant factor increasing the incidence of ventricular arrhythmia, conduction disturbances and ST-segment depression episodes in Holter monitoring. Int J Occup Med Environ Health. 2022;35(3):353-60.

Electrocardiographic Risk Stratification in COVID-19 Patients.

Background: The COVID-19 pandemic has resulted in worldwide morbidity at unprecedented scale. Troponin elevation is a frequent laboratory finding in hospitalized patients with the disease, and may reflect direct vascular injury or non-specific supply-demand imbalance. In this work, we assessed the correlation between different ranges of Troponin elevation, Electrocardiographic (ECG) abnormalities, and mortality.Methods: We retrospectively studied 204 consecutive patients hospitalized at NYU Langone Health with COVID-19. Serial ECG tracings were evaluated in conjunction with laboratory data including Troponin. Mortality was analyzed in respect to the degree of Troponin elevation and the presence of ECG changes including ST elevation, ST depression or T wave inversion.Results: Mortality increased in parallel with increase in Troponin elevation groups and reached 60% when Troponin was >1 ng/ml. In patients with mild Troponin rise (0.05–1.00 ng/ml) the presence of ECG abnormality and particularly T wave inversions resulted in significantly greater mortality.Conclusion: ECG repolarization abnormalities may represent a marker of clinical severity in patients with mild elevation in Troponin values. This finding can be used to enhance risk stratification in patients hospitalized with COVID-19.

The relationship among periodontal condition, serum lipid, and electrocardiographic abnormalities in the elderly: A prospective cohort study

Periodontal disease is recognized as a risk factor for cardiovascular disease (CVD). Some studies have suggested that serum lipids might play a role in the association between periodontal disease and CVD. However, this hypothesis remains unproven. Present study evaluated the association between periodontal disease and CVD-related parameters including electrocardiographic (ECG) parameters and serum lipid levels in the elderly. This study was a prospective cohort study. A total of 107 subjects (57 males and 50 females) from Niigata City’s community-dwelling elderly (all aged 75 years old) who possessed at least 20 teeth and did not exhibit ECG abnormalities at the baseline underwent annual examinations for 5 years. Logistic regression analysis was used to assess the relationship between periodontal condition and the presence of ECG abnormalities, after adjusting for confounding factors including serum lipid levels. Logistic regression analysis showed that the subjects who exhibited a poor periodontal condition at the baseline had a 2.97 times greater risk of suffering from ECG abnormalities than the subjects who displayed a good periodontal condition at the baseline (p = 0.019). Furthermore, the subjects who displayed a poor periodontal condition and an unfavorable serum lipid profile at the baseline showed a significantly higher frequency of ECG abnormalities (63.6%) than those who exhibited a healthy periodontal condition and a favorable serum lipid profile (21.6%, p = 0.008) as well as those who displayed a healthy periodontal condition and an unfavorable serum lipid profile (21.4%, p = 0.010). As a conclusion, periodontal condition could be a marker of CVD, even in the healthy elderly.

Alteraciones electrocardiográficas en la hemorragia subaracnoidea

It has been described a great variety of electrocardiographic abnormalities in the acute phase of the subarachnoid hemorrhage (SAH), which are more frequent in patients with severe neurologic impairment and when there is myocardial damage. The presence of electrocardiographic tracings compatible with acute myocardial infarction (AMI) in the acute phase of the SAH is rare. We present a 77-year-old patient with an extensive SAH and an electrocardiographic pattern suggesting anterior transmural AMI, with a fatal outcome in a few hours. It should pay more attention to the possibility of cardiac complications in the SAH. Myocardial ischemia and SAH may coexist. The presence of electrocardiographic abnormalities in the acute phase of the SAH is not always indicative of cardiac pathology.

Marked variation in the cardiomyopathy associated with Friedreich’s ataxia

ObjectiveTo document the cardiac phenotype associated with Friedreich’s ataxia, a recessively inherited disorder characterised by spinocerebellar degeneration.SettingIndividuals with Friedreich’s ataxia who accepted the invitation to participate in the study.HypothesisThe cardiomyopathy...

Association of insulin resistance to electrocardiographic changes in non obese asian indian subjects with hypertension

To investigate the relationship between insulin resistance and electrocardiographic changes in hypertension in the absence of confounding influences, plasma glucose and insulin responses to oral glucose were studied in 26 normotensive and 38 hypertensive subjects. Resting ECG was taken and classified into normal or abnormal using the Minnesota code. Among the 38 subjects, 16 had ECG abnormalities. All the hypertensive subjects had normal glucose tolerance. Serum insulin response of hypertensive subjects with ECG changes was 43% higher than those of hypertensive subjects without ECG changes and of normotensive subjects. The ratio AUC glucose/AUC insulin, a measure of insulin sensitivity was significantly reduced in subjects with abnormal ECG. Serum LDL cholesterol was significantly elevated and was the highest in hypertensive subjects with abnormal ECG. The ratio, Total Cholesterol/HDL Cholesterol was elevated to 5.8±0.47.125-insulin binding to erythrocytes from 6 normotensive subjects, and 16 hypertensive subjects (8 with and 8 without ECG abnormalities) indicated 50% reduction in insulin receptor number in both the groups of hypertensive subjects compared to normotensive subjects. Multiple logistic regression analysis using mean blood pressure, serum total cholesterol, LDL cholesterol/HDL cholesterol, sex, insulin level at 60min in OGTT, treatment, serum triglyceride, presence of family history of diabetes, CHD, hypertension and tobacco as independent variables causing ECG changes, revealed correct classification in 84% of cases. Among the variables, insulin level in OGTT contributed the most to ECG abnormalities. The data suggest that in the non obese, non diabetic Asian Indian hypertensive subjects, the presence of electrocardiographic abnormalities might be partly related to hyperinsulinemia or insulin resistance in them.

CARDIAC INVOLVEMENT IN RHEUMATOID ARTHRITIS-A CLINICAL STUDY-

1. In order to determine the incidence of the cardiac involvement in rheumatoid arthritis (RA), electrocardiographic, mechanocardiographic and echocardiographic studies were carried out on 92 patients.2. Electrocardiographic abnormalities were found in 31 of 92 cases (34 %). A slight left axis deviation from 0 to-30°, sporadic ventricular premature beats and T wave changes were frequent findings.3. Although the systolic pressure was significantly higher in the presence of electrocardiographic abnormalities, electrocardiographic findings has no obvious relationship with the cardiothoracic ratio, heart rate, hemoglobin concentration or the result of RA test.4. The preejection period/left ventricular ejection time ratios measured in 10 patients were almost the same as in the normal subjects, although the values tended to be greater in the cases with increased erythrocyte sedimentation rate and/or low hemoglobin concentration.5. Echocardiography revealed evidences of pericardial effusion in 3 of 11 cases, while routine electrocardiograms and chest x-ray films were not contributory. The usefulness of echocardiography to detect a cardiac involvement in RA was suggested.

Electrocardiographic alterations in diphtheria.

Electrocardiographic abnormalities in five cases of diphtheria have been described. The abnormalities found were grade I and Wanckebach’s A-V block, low voltage QRS, partial or complete left bundle branch block, premature beats and an infarction-like pattern. It is observed that the prognosis of myocarditis is not necessarily bad even in the presence of electrocardiographic abnormalities.