Electrocardiographic Results Research Articles

Results of electrocardiography in children born at very early preterm birth

Background. Children born at extremely early preterm birth (EPL) are at high risk of developing cardiovascular diseases, including heart rhythm disorders (HRDs) and conduction disorders throughout life.Objective: To study electrocardiographic features in children of the first year of life born at term SPR.Materials and methods. The main group consisted of 51 children born at term. Depending on body weight, the main group was divided into 2 subgroups. Subgroup 1 consisted of children weighing 500-750 g (n=15). Subgroup 2 — children weighing 751 g or more (n=36). The comparison group included 28 children born at a gestational age of 32-36 weeks. Children were examined at the ages of 6 and 12 months. Electrocardiography was performed on children at rest in 12 standard leads with a paper tape speed of 50 mm/sec. Analysis of ECG indicators was carried out using a Sicard electrocardiograph from Siemens AG, according to generally accepted methods.Results and discussion. In children born at gestational age during 1 year of life, clinical manifestations of impaired functional state of the cardiovascular system were observed in the form of vegetative-vascular dysfunction, NSR, and changes in the characteristics of heart sounds. According to the ECG results, NSR was identified in the form of sinus arrhythmia, sinus tachy- and bradycardia, extrasystole, atrial rhythm, pacemaker migration, supraventricular paroxysmal tachycardia, WPW syndrome, long QT interval syndrome, which amounted to 86.7% of cases in children of subgroup 1, in children of the 2nd subgroup 82.2% and 60.7% in children of the comparison group. A direct strong correlation has been established between the clinical manifestations of autonomic dysfunctions at the age of 12 months and the frequency of identified dysfunctions. By 12 months of life, the number of children with sinus bradycardia, sinus arrhythmia and ectopic rhythm increases. There is no positive trend in the frequency of detection of ECG phenomena during the first year of life.Conclusion. Children born at very early preterm birth require cardiac monitoring, including blood pressure measurement, electrocardiography and the development of personalized clinical follow-up programs.

Feasibility of Early Assessment for Psychological Distress: HRV-Based Evaluation Using IR-UWB Radar.

Mental distress-induced imbalances in autonomic nervous system activities adversely affect the electrical stability of the cardiac system, with heart rate variability (HRV) identified as a related indicator. Traditional HRV measurements use electrocardiography (ECG), but impulse radio ultra-wideband (IR-UWB) radar has shown potential in HRV measurement, although it is rarely applied to psychological studies. This study aimed to assess early high levels of mental distress using HRV indices obtained using radar through modified signal processing tailored to reduce phase noise and improve positional accuracy. We conducted 120 evaluations on 15 office workers from a software startup, with each 5 min evaluation using both radar and ECG. Visual analog scale (VAS) scores were collected to assess mental distress, with evaluations scoring 7.5 or higher classified as high-mental distress group, while the remainder formed the control group. Evaluations indicating high levels of mental distress showed significantly lower HRV compared to the control group, with radar-derived indices correlating strongly with ECG results. The radar-based analysis demonstrated a significant ability to differentiate high mental distress, supported by receiver operating characteristic (ROC) analysis. These findings suggest that IR-UWB radar could be a supportive tool for distinguishing high levels of mental stress, offering clinicians complementary diagnostic insights.

Implementasi K-Means Clustering pada Pengelompokan Pasien Penyakit Jantung

Heart disease is a prominent global health concern, necessitating early identification and patient grouping for effective management. This study employs the K-Means clustering algorithm with a medical dataset of 303 patients, encompassing various attributes. These include Age, Gender, Chest Pain Type, Blood Pressure, Serum Cholesterol Level, Fasting Blood Sugar, Resting Electrocardiographic Results, Maximum Heart Rate, Angina, ST Depression, and Slope of the ST Segment. The goal is to categorize patients into four clusters based on chest pain types, a crucial symptom indicating disease severity. The computation concludes after the sixth iteration, revealing Cluster 1 (27 patients), Cluster 2 (135 patients), Cluster 3 (15 patients), and Cluster 4 (126 patients). Collaborative analysis with medical experts highlights that Cluster 1, mainly comprising older males, exhibits high-risk indicators. While this grouping aids in personalized treatment strategy development, further clinical validation involving more experts and datasets is imperative for enhanced reliability.

Short- and long-term prognostic performance of exercise ECG and myocardial perfusion SPECT.

Myocardial perfusion SPECT(MPS) and exercise electrocardiography(Ex-ECG) results are of prognostic importance for short-term follow up duration. However, the value of MPS or Ex-ECG findings for long-term risk assessment is less evident as underlying risk factors for ischemic heart disease (IHD) gain in importance. To assess the short- and long-term prognostic value of MPS and Ex-ECG in relation to known risk factors. An observational study of 908 patients (age 63 years, 49% male, 45% prior IHD) referred for MPS and Ex-ECG. Follow-up was divided into two periods (short-term: <5 years and long-term: >5 years). Cardiac events were defined as a composite of acute myocardial infarction, unstable angina, unplanned revascularization and cardiovascular death. The composite endpoint occurred in 95 patients (short-term follow up) and in 94 patients (long-term follow up). In multivariable models stress testing had a strong predictive value for short-term follow up (HR for MPS = 2.9, CI = 1.9-4.5, p < 0.001 and HR for Ex-ECG = 2.1, CI 1.3-3.3, p = 0.002), but no predictive value for long-term follow up (HR for MPS = 0.9, CI = 0.5-1.5, p = 0.70 and HR for Ex-ECG = 1.0, CI = 0.6-1.6, p = 0.92). Male sex and prior IHD were significant predictors regardless of follow up duration. Age, diabetes and decreased exercise capacity were risk factors for long-term follow up. The prognostic value of MPS and Ex-ECG results are strong for short-term follow up but diminish over time and do not contribute significantly in multivariable models after 5 years. Long-term prognosis is primarily governed by underlying risk factors and exercise capacity.

Effect of Coenzym Q10 on Doxorubicin-induced Cardiotoxicity in Non Hodgkin's Lymphoma Patients

BACKGROUND : Non-Hodgkin's Lymphoma is a primary malignancy in the Lymph Nodes and lymphoid tissue originating from B lymphocytes, T lymphocytes and Natural Killer (NK) cells. Therapy for Non-Hodgkin's Lymphoma chemotherapy can be given alone or combined with radioactive therapy. Doxorubicin is a chemotherapy drug used for lymphoma with side effects, one of which is cardiotoxic effects. AIMS : To prove that coenzyme Q10 can reduce the cardiotoxic effect of doxorubicin chemotherapy in non-Hodgkin's lymphoma patients METHOD : Intervention study with a randomized pre and post test double blind control group design with 34 NHL patients undergoing chemotherapy. The treatment group received additional therapy with coenzyme Q10 300mg/day for 12 weeks while the controls received placebo. The cardiotoxic effects examined were assessed based on the results of Electrocardiography and Echocardiography. RESULT : The treatment group with coenzyme Q10 supplementation after the 4th chemotherapy showed a decrease in echocardiography results in 3 patients (18%) and in the control group 17 patients (100%). There was a significant difference in the echocardiography results of the treatment and control groups (p=0.001). There were no drug side effects in both groups CONCLUSION : Coenzyme Q10 supplementation provides an improvement in the cardiotoxic effects of doxorubicin in non-Hodgkin's lymphoma patients, on echocardiography, but not on Electrocardiography.

Risk Factor Profile and Role of Cardiovascular Disease Outreach Program by Experts in Rural Communities: A Pilot Study in Magetan Regency, Indonesia

Cardiovascular outreach programs and risk factors profiling have been regarded as key strategy in preventing and controlling cardiovascular diseases as the leading global causes of death worldwide, especially when being conducted by a professional. This pilot study aims to evaluate the effectiveness of a cardiovascular outreach program in Plaosan District, Magetan Regency, to improve knowledge and influence changes in the community’s behavior related to cardiovascular risk factors. This study was conducted by providing educational interventions and profiling cardiovascular risk factors on 90 adults using consecutive sampling method. Health education was performed by experts and evaluated by pre-post tests before and after the material delivery. Statistical analysis was used to assess the relationship of risk factors that can contribute to cardiovascular disease. This study showed a significant increase in the participants' knowledge score after the intervention (p = 0.007). There were several risk factors for cardiovascular disease in the participants, with the highest risk prevalence being diabetes mellitus (33.33%). Six participants (6.67%) had abnormal electrocardiography results. In conclusion, our study showed a high prevalence of cardiovascular risk factors in rural communities and the importance of cardiovascular outreach programs by experts to improve the understanding of cardiovascular disease in a specific community.

Differences in the serum lipid profile of goats with varying autonomic nervous system tone

Goat farming is a promising branch of animal husbandry, as statistics show a rapid increase in global demand for goat milk and meat products. To meet market demand, new methodological approaches are needed to improve animal productivity while maintaining the quality of the raw materials. In this context, this study aims to determine the impact of autonomic nervous system tone on lipid metabolism in goats. The study involved Saanen goats, with the experimental groups formed based on the results of variation-pulsometric study and electrocardiography, followed by the determination of autonomic nervous system tone using the Baevsky method. The serum lipid profile of goats was studied using a LabLine-010 spectrophotometer. The following indicators were biochemically analysed in serum samples: content of triacylglycerols, cholesterol, high-density, low-density, and very-low-density lipoproteins, and the atherogenic index was calculated. It was established that the content of triacylglycerols was 23% lower (P&lt; 0.05) in sympathotonic animals and 41% lower (P&lt; 0.001) in vagotonic animals compared to normotonic animals. The level of lowdensity lipoproteins in the blood serum of sympathotonic animals decreased by 40% (P &lt; 0.05), and in vagotonic animals – by 76% (P&lt; 0.01), relative to normotonic animals. The content of highdensity lipoproteins in sympathotonic animals increased by 36% (P&lt;0.001), relative to normotonic animals. The level of cholesterol in the blood serum of goats differed by 16% (P &lt; 0.01) in sympathotonic animals and 15% (P&lt; 0.01) in vagotonic animals compared to normotonic animals. A significant influence of autonomic nervous system tone on the processes of maintaining lipid homeostasis in goats was determined. Taking into account the individual features of the influence of the autonomic nervous system on lipid metabolism when distributing animals will contribute to the effective adjustment of diets. After all, each animal has a different tone of the autonomic nervous system, which significantly affects the features of substance transformation in its body

Systemic Vascular Parameters in Ocular Pseudoexfoliation.

Background Pseudoexfoliation syndrome (PEX) is characterized by a dandruff-like substance in the anterior chamber, composed of various glycoproteins that have an unclear origin. Its deposition is observed on the pupillary margin, lens zonules, and trabecular meshwork. Proteomic studies have identified numerous proteins in the affected individuals, suggesting associations with systemic conditions like heart disease, stroke, and Alzheimer's disease. However, the systemic associations of PEX remain inconclusive, particularly in regions like southern India. Materials and methods A cross-sectional study was conducted on 114 participants. Pseudoexfoliation was graded as mild, moderate, and severe as per standard photographic grading. Systemic examinations included blood pressure measurements, electrocardiography (ECG), and blood investigations for serum lipid profile, fasting and postprandial blood sugar levels, and serum C-reactive protein levels. Small incision cataract surgery was performed for all the patients. Intraoperative complications and postoperative status were recorded. Results Thirty-eight patients (33.3%) had mild PEX, 44 (38.6%) had moderate PEX, and 32 (28.1%) had severe PEX. Hypertension was present in 54 participants (47.4%), diabetes in 21 (18.4%), coronary artery disease in nine (7.9%), and cerebrovascular accidents in three (2.6%). The mean systolic blood pressure was 140.39 mmHg and the mean diastolic blood pressure was 90.37 mmHg. Systolic blood pressure exceeded 140 mmHg in 29 participants (90.6%) with severe PEX, while diastolic blood pressure surpassed 90 mmHg in 26 participants with severe PEX, both with a p-value of 0.001. Mean fasting and postprandial blood sugar levels were 103.80 ± 31.81 mg/dl and 131.72 ± 48.24 mg/dl, respectively. Serum lipid profiles showed mean low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), cholesterol, and triglyceride levels of 103.00 ± 34.49 mg/dl, 29.04 ± 15.51 mg/dl, 172.73 ± 43.34 mg/dl, and 129.33 ± 64.65 mg/dl respectively. Electrocardiographic results indicated that 54 participants (47.37%) had abnormal ECG including rate abnormality in 13.2%, conduction defects in 12.3%, ischemic changes in 10.5%, and structural defects in 11.4%. Eighty-seven percent of patients had non-dilating pupils and iris atrophy, 13.2% had zonular dialysis and intraoperatively, 78% had capsulorhexis extension, 49.12% had difficult nucleus prolapse, and 28.95% had posterior capsular rent. Conclusion This study highlights the significantly elevated parameters of systemic vascular diseases in PEX patients, like elevated blood pressure and more frequent cardiac anomalies, emphasizing the need for comprehensive systemic evaluation and careful preoperative assessment for ocular comorbidities.

ЗНАЧЕНИЕ ОФЭКТ/КТ В ОДНОВРЕМЕННОЙ ОЦЕНКЕ КАЛЬЦИНОЗА КОРОНАРНЫХ АРТЕРИЙ, ПЕРФУЗИИ И КОНТРАКТИЛЬНОЙ ФУНКЦИИ МИОКАРДА У МУЖЧИН С ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА

Purpose: To study the frequency of calcinosis of coronary arteries and its effect on myocardial perfusion and contractile function among men’s with coronary heart disease (CHD). Material and methods: A survey was conducted among 1175 men’s aged 30 to 83 years with coronary artery disease (CHD): simultaneous assessment of coronary artery calcinosis, perfusion and contractile function with 99m Tc-MIBI using SPECT/CT with ECG-synchronization and X-ray radiation attenuation correction, as well as comparison of data with the results of electrocardiography (ECG), echocardiography (ECHO-CG), clinical and biochemical blood tests. Results: Of the 1175 men examined using SPECT/CT, coronary artery calcification was detected in 426 (35 %): in the age group over 55 years old – in 142 (12 %), in the age group 46−55 years old – in 200 (17 %), in the age group 27–45 years old – in 74 (6 %). The interval of calcium index indicators in accordance with the Agatston scale was established as follows: at the maximum degree &gt; 400 units – in 87 males (7 % of all examined); at 101−400 units – at 121 (10 %); at 11−100 units – at 162 (14 %); at 1−10 units – in 46 (4 %); with a minimum degree − of 0 units – in 759 men (65 % of all examined). In 34 men of whom 15 had coronary calcification and 19 did not have it, perfusion index (SPB) was either normal or corresponded to the initial degree of decrease in perfusion, and contractile function was slightly impaired, the ejection fraction was not reduced. Conclusion: The use of SPECT/CT technology with ECG-synchronization and CT-attenuation correction of radiation, in 1175 men with CHD made it possible to detect coronary calcification in 35 %: at the age of 55 years in 12 %, at the age of 46–55 years in 17 %, at the age of 27–45 years – in 6 %. In men with CHD without acute coronary events, both with and without coronary calcinosis, SPB was either normal or corresponded to the initial degree of reduced perfusion, and contractile function was slightly impaired, EF was not reduced. Three years later, in men whose coronary artery calcification was moderate despite its increase to a high degree, the perfusion (SPB) and contractile function indicators did not significantly change, and such indicators did not significantly change in the absence of coronary artery calcification.

#2814 Characterization of cardiological manifestations in patients with sodium-wasting tubulopathies

Abstract Background and Aims Bartter (BS) and Gitelman (GS) syndromes are rare tubulopathies caused by mutations affecting renal NaCl transporters, resulting in similar symptoms like muscle weakness, cramps, and electrolyte imbalances, with GS also presenting with hypomagnesemia. Treatment focuses on electrolyte and fluid balance, using supplements and drugs to inhibit prostaglandin production and RAAS activation. Electrolyte deficits in these conditions can extend the QT interval and increase the risk of potentially fatal cardiac arrhythmias. This study aims to profile BS and GS patients followed at our hospital, focusing on cardiological phenotyping. We assessed diagnostic, clinical, and lab data, particularly examining the link between electrolyte imbalances (like hypokalemia or hypomagnesemia) and electrocardiographic changes or cardiac symptoms during follow-up. Method We screened all BS and GS patients for study inclusion, requiring a genetic diagnosis with disease-causing mutations and comprehensive clinical and electrocardiographic data. We excluded cases lacking sufficient data. We gathered demographic and health information retrospectively, categorizing patients based on electrocardiographic results into groups: 1) persistent long QT interval, 2) transient long QT interval, and 3) no long QT interval. Data were summarized with medians, interquartile ranges, and frequencies. Results A total of 27 patients were enrolled in the study, 16 with Bartter Syndrome (BS) and 11 with Gitelman Syndrome (GS); median length of follow-up was 6 years (range 3-19). Only one patient was classified in group 1, with a constant QTc prolongation (446.3 ms); 8 patients (34.8%) fell into group 2 with median QTc values of 420 ms, all exhibiting hypokalemia and hypomagnesemia. The majority (14/23, 61%) were in group 3, with a median QTc of 399.2 ms and 79% displaying hypokalemia and hypomagnesemia. All 9 patients who experienced cardiac-related symptoms were adults, with 8 presenting these symptoms during intercurrent episodes. The study also compared clinical differences between BS and GS patients, noting a higher frequency of hypokalemia and hypomagnesemia in GS, whereas BS patients had more electrocardiographic alterations, although not statistically significant. No echocardiographic abnormalities were detected from the available data, and there were no recorded incidents of malignant arrhythmias or sudden death. Conclusion Electrocardiographic abnormalities in BS and GS patients fluctuate, often related to episodic events, with QT prolongation in one-third of cases but no severe cardiac complications, indicating a generally positive prognosis.

First Report of Seropositivity to Trypanosoma cruzi in Mexican Afro-Descendants from Guerrero and Oaxaca States.

Mexican Afro-descendant is a population poorly studied in many aspects, between them the infectious diseases that they suffer. This population is mainly found in the country's Pacific (Oaxaca and Guerrero states) and Atlantic (Veracruz) coast. In these regions, a diversity of triatomine vectors of the Chagas disease is found. Also, all the genotypes of Trypanosoma cruzi DTUs have been reported. That is why the present study aimed to study the presence of antibodies against T. cruzi and cardiac pathology associated with the Chagas disease in the Mexican Afro-descendant population of Guerrero and Oaxaca. ELISA, Western blot, and recombinant antigen's ELISA were used to evaluate the seropositivity of these communities. Furthermore, an electrocardiographic study and evaluation of risk factors associated with T. cruzi infection in the Oaxaca and Guerrero populations were conducted. 26.77% of the analyzed population was positive for two serological tests. These percentages are higher than the previously reported for the mestizo population in similar studies. Electrocardiographic results showed cardiac disorder associated with the Chagas disease in the population. Also, risk factors were identified associated with the men's activities in the outdoor working areas.

Is Reiki effective in reducing heart rhythm, cortisol levels, and anxiety and improving biochemical parameters in individuals with cardiac disease? Randomized placebo-controlled trial.

The aim of this study was to examine the effect of Reiki in patients with cardiac disease. This study was a single-blind, pre-post-test, randomized, placebo-controlled study. Patients from the cardiology outpatient clinic of a training and research hospital were randomized into three groups: Reiki (n = 22), sham (placebo) (n = 21), and control (no treatment) (n = 22). Data were collected using a personal information form, biochemical parameters, cortisol levels, Beck Anxiety Inventory, and electrocardiography analysis. The Reiki group received Reiki to nine main points for 30 min, while the sham Reiki group received the same points during the same period without starting the energy flow. On Day 2, distance Reiki was performed for 30 min. After 1 week, the researchers administered the Beck Anxiety Inventory, assessed the biochemical parameters and cortisol levels, and analysed the electrocardiography again. Of the patients, 52.3% were male and 47.7% were female, and the mean age (years) was 60.45 ± 9.67 years. The control group had a significantly higher post-test cortisol level than the other groups (P = 0.002). According to the post hoc analysis, there was a significant difference between the Reiki vs. control groups and sham vs. control groups (P = 0.002). The control group had a significantly higher post-test cortisol level than the pre-test cortisol level (P = 0.008). Reiki group had a significantly lower mean post-test Beck Anxiety Inventory score than the other groups (P < 0.001). There was no difference between the electrocardiography results of the groups (P > 0.05). Reiki reduces blood cortisol levels and anxiety levels in patient with cardiac diseases. ClinicalTrials.gov: NCT05483842.

Non‐Invasive Flexible Electro‐Mechanical Sensors for Human Respiratory Monitoring and Chronic Disease Management

AbstractAs one of the important physiological signals of the human body, changes in respiration can provide an important reference for human health and is an early warning signal for some chronic respiratory diseases on heart or lung diseases. Usually, doctors combine such changes with electrocardiograph (ECG), electroencephalograph (EEG), electromyography (EMG), and electrooculogram (EOG) results of the patient to make a comprehensive analysis and judgment of the condition. Traditional respiratory monitoring methods have the limitation that portability and accuracy cannot be balanced; while the wearable respiratory monitoring sensors have come into the public's view due to their excellent performances, such as light weight, fast response, not interfering with the subject's daily movement, and maintaining excellent measurement accuracy, which provide more possibilities for the improvement of the performances of the wearable devices applied in the early stage of chronic diseases.

Correlation of osteopontin hormone with TIMI score and cardiac markers in patients with acute coronary syndrome presenting with chest pain.

Rapid evaluation of patients with acute coronary syndrome (ACS) attending the emergency service under emergency room conditions and using appropriate risk scoring would improve treatment success. Calcium levels accumulate in the tissue in people with coronary artery disease and this has been found to correlate with osteopontin levels in some studies. It is predicted that osteopontin level could be used as a biomarker to detect coronary artery calcification. In this study, we aimed to evaluate the use of osteopontin levels in the differential diagnosis of ACS in conjunction with cardiac troponin I (cTnI) levels, and HEART (history, ECG, age, risk factors, troponin) and thrombolysis in myocardial infarction (TIMI) scores in patients with chest pain who attended the emergency service. This study was conducted as a prospective observational clinical study in the Department of Emergency Medicine, Faculty of Medicine, Ataturk University. There was a total of 90 participants, including 60 patients and 30 healthy individuals in the control group. All participants' demographic information, electrocardiography (ECG) findings, cTnI level, TIMI and HEART score, and osteopontin level were evaluated. The patients' mean age was 51.61 ± 17.56 years and 63.3% (n = 57) were male. The body mass index (BMI) of the patients was 25.63 ± 4.67 kg/m2. Patients with chest pain [CP(+)] and high cardiac troponin I levels [cTnl(+)] were found to be older and to have higher HEART and TIMI scores than individuals with CP(+) and normal cardiac troponin I levels [cTnl(-)] and the healthy control group (p < 0.001). While the HEART score was zero in 22 (24.4%) of the patients, the TIMI score was zero in 42 (46.7%). In terms of gender distribution, vital signs and serum osteopontin levels, there was no significant difference between the patient groups (p > 0.05). It was found that patients with CP(+) and cTnl(+) had a higher rate of ECG abnormalities than the CP(+) and cTnl (-) group and the healthy control group (p = 0.13 and p < 0.001, respectively). In 65 (72.2%) of the patients, the ECG results were normal. ST-segment elevation was detected in 13 (14.4%) patients. In our study, cTnl levels were found to be positively correlated with age (r = 0.624), BMI (r = 0.291), HEART score (r = 0.794) and TIMI score (r = 0.805) (p = 0.001, p = 0.005, p = 0.001 and p = 0.001, respectively). In our study, we discovered that osteopontin levels could not reach the differential diagnostic level for ST-elevation myocardial infarction or non-ST-elevation myocardial infarction. No statistically significant difference was found in osteopontin levels between the groups (p > 0.05). While very positive results were obtained in this approach to the ACS diagnosis using HEART and TIMI scores in patients with chest pain who attended the emergency service and were diagnosed with ACS, no significant results could be obtained regarding the use of osteopontin levels as a biomarker. More comprehensive, multicentre studies involving a large number of appropriately selected patients are considered to be necessary.

ЗНАЧЕНИЕ ОФЭКТ/КТ ДЛЯ ОДНОВРЕМЕННОЙ ОЦЕНКИ КАЛЬЦИНОЗА КОРОНАРНЫХ АРТЕРИЙ, ПЕРФУЗИИ И КОНТРАКТИЛЬНОЙ ФУНКЦИИ МИОКАРДА У ЖЕНЩИН С ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА

Purpose: To study the frequency of calcinosis of coronary arteries and its effect on myocardial perfusion and contractile function among females with coronary heart disease (CHD). Material and methods: A survey was conducted among 141 females with coronary heart disease (CHD): simultaneous assessment of coronary artery calcinosis, perfusion and contractile function with 99m Tc-technetril SPECT/CT with ECG-synchronization and X-ray radiation correction, as well as comparison of data with the results of electrocardiography (ECG), echocardiography (ECHO-CG), clinical and biochemical blood tests. Results: Coronary artery calcinosis was detected in 33 (23 %) females with coronary heart disease (CHD) out of all patients identified: over the age of 55 years (M = 67 years with variations from 58 to 83 years) ‒ in 25 (17.7 %), aged 41‒55 years (M = 50 years with variations from 46 to 54 years) ‒ in 7 (4.6 %), at the age of 25‒40 years ‒ in one female 35 years (0.7 %). The Agatston calcium score interval was set as follows: at the maximum degree &gt; 400 ‒ for 6 females (4.2 % of all surveyed); at 101‒400 ‒ in 9 (6.4 %); at 11‒100 ‒ in 17 (12.0 %); at 1‒10 ‒ in one female (0.7 %); with a minimum degree of 0 ‒ in 108 females (76.7 % of all surveyed). In the presence of maximum degree of calcinosis (&gt; 400 units), a slight significant decrease in perfusion, an increase in ejection fraction and diastole duration was revealed. Conclusion: The use of combined SPECT/CT with ECG synchronization and CT radiation correction technology in 141 females with coronary artery disease made it possible to identify coronary artery calcinosis in 23 % of patiets.

Assessment of cardiac arrhythmias, P wave and QT dispersion in systemic sclerosis

Cardiac involvement in systemic sclerosis (SSc) is significant cause of SSc-related mortality. The objective of the study was to assess cardiac arrhythmias, P wave and QT dispersion in SSc patients. 40 SSc patients and 40 healthy participants who had similar sociodemographic characteristics with the patients were enrolled in the study. P wave dispersion (Pd), QT dispersion (QTd), and corrected QT (QTc) dispersion (QTcd) were calculated by measuring maximum (max) and minimum (min) of P wave, QT interval, QTc in 12-leads electrocardiography (ECG). Cardiac arrhythmias and conduction disorders were assessed by ECG and Holter-ECG. The mean age of SSc patients (92.5% of females) was 50.9±13.9 years similar with the healthy group (51.4±8.9). Abnormal ECG findings were found in 27.5% of SSc patients and remarkably higher in comparison to the healthy participants (p=0.019). The most frequently reported abnormal ECG findings were left anterior fascicular block (15%), ventricular premature beat (10%) and first-degree atrioventricular heart block (5%). The comparison of dispersion showed no statistically important difference in Pd between two groups (p=0.69) while QTd, QTc, QTcd, QTc min, and QTc max were markedly prolonged in patients with SSc (p=0.039; p&lt;0.001; p=0.021; p&lt;0.001; p&lt;0.001, respectively). The assessment of Holter-ECG demonstrated that supraventricular tachycardia was frequently detected in patients with SSc (22.5% vs 2.5%; p=0.007). This study indicated a significantly elevated incidence of abnormal ECG results and SVT, an arrhythmia not typically identifiable through standard ECG but detectable via Holter monitoring, in patients with SSc. In the study, QTd, QTc, and QTcd intervals were significantly longer in SSc patients, which may indicate a susceptibility to arrhythmias.

Resting Heart Rate Independent of Cardiovascular Disease Risk Factors Is Associated With End-Stage Renal Disease: A Cohort Study Based on 476 347 Adults.

The relationship between resting heart rate (RHR) and the risk of end-stage renal disease (ESRD) among those without cardiovascular disease remains unclear. We aim to establish temporal consistency and elucidate the independent relationship between RHR and the risk of ESRD. This cohort enrolled participants from 476 347 individuals who had taken part in a screening program from 1996 to 2017. We identified 2504 participants who had ESRD, and the median follow-up was 13 years. RHR was extracted from electrocardiography results, and the study assessed the relationship between RHR and the risk of ESRD using the Cox proportional hazards model. Of the participants, 32.6% had an RHR of 60 to 69 beats per minute (bpm), and 22.2% had an RHR of ≥80 bpm. Participants with an RHR of ≥80 bpm had a higher stage of chronic kidney disease, lower estimated glomerular filtration rate, and more proteinuria than those with an RHR of 60 to 69 bpm. Participants with an RHR of 80 to 89 and ≥90 bpm had a 24% (hazard ratio [HR], 1.24 [95% CI, 1.09-1.42]) and 64% (HR, 1.64 [95% CI, 1.42-1.90]) higher risk of ESRD, respectively. The risk of ESRD remained significantly elevated (HR, 1.32 [95% CI, 1.10-1.58] per 10-beat increase from 60 bpm) after excluding participants who smoked; had hypertension, diabetes, or hyperlipidemia; or were overweight. An RHR of ≥80 bpm is significantly associated with an increased risk of ESRD. These results suggest that RHR may serve as a risk factor for kidney disease in individuals without established cardiovascular disease risk factors.

"Quick flutter skip": midlife women's descriptions of palpitations.

The objective of this study is to describe peri- and postmenopausal women's experiences of palpitations (quality, frequency, severity, distress, duration and temporal pattern, aura, associated symptoms, and aggravating/alleviating factors) and related healthcare experiences. Qualitative descriptive methods were used. Semistructured interviews were conducted with women who reported palpitations and were enrolled in a larger case-control pilot study comparing electrocardiographic results between women with and without palpitations. Authors analyzed women's narratives using standard content analytic procedures. Fourteen participants (mean age, 54.5 y [SD = 4.8 y]; range, 46-62 y; 79% postmenopausal) completed interviews. The interviews revealed that women (a) often had difficulty describing their palpitations until prompted by the interviewer; (b) experienced noteworthy variations in the quality and other dimensions of their palpitations; (c) had a wide variety of healthcare experiences related to their palpitations, including not reporting their symptoms to providers, having providers dismiss their symptoms, and having providers be aware of their symptoms and provide diagnostic tests; and (d) at times, created worst case scenarios (downward shifts) under which they would seek treatment for their palpitations, thus enabling them to minimize their symptoms and avoid healthcare. This study advances understanding of how women describe their palpitations and related healthcare experiences. Findings could have implications for building research and clinical tools to guide assessment, communication, and/or education for patients and/or providers about palpitations and for developing and testing behavioral interventions to address this poorly understood symptom in peri- and postmenopausal women.

Electrocardiographic measurements in children with pre-dialysis chronic kidney disease and undergoing kidney replacement therapy.

Cardiovascular diseases are the main causes of morbidity in children with chronic kidney disease (CKD). Electrocardiography (ECG) can provide important information about cardiac functions and parameters associated with sudden cardiac death. This study aims to evaluate the potentially dangerous changes in CKD and kidney replacement therapies by ECG and to determine the value of ECG in predicting cardiovascular outcome compared with echocardiography. 101 patients with CKD were divided into subgroups according to treatment modalities as pre-dialysis CKD, hemodialysis (HD), peritoneal dialysis (PD) and kidney transplantation (KTx). Differences in anthropometric measurements, laboratory results, blood pressures, ECG monitoring were compared within groups as well as with 40 healthy controls. Available echocardiographic findings were noted. In the patients, HD group had highest frequency of hypertension. ECG revealed prolonged QTc as more frequent (16.8% vs 0%, p = 0.006) and higher QTcD (56.7 ± 6.5 vs 39.9 ± 5.1ms, p = 0.001) in the patients compared to controls, especially in dialysis patients, whereas lowest values were in KTx subgroup. Left ventricular (LV) hypertrophy (LVH) was more frequent (47.1%) in HD compared to other CKD subgroups in ECG (p = 0.052). Echocardiography also showed LV mass index as highest in HD and lowest in KTx (121.4 ± 55.7 vs 63.7 ± 18.3g/m2, p = 0.000), with numerically highest LVH in HD (58.3%, p = 0.063). Conclusion: ECG can be used to detect cardiovascular problems in patients with CKD, especially in HD. As ECG results were in line with echocardiography, patients with ECG abnormalities suggestive of LVH should be referred for echocardiographic assessment. What is Known: • Cardiovascular diseases such as coronary artery disease, congestive heart failure, arrhythmias and sudden cardiac death are major causes of morbidity and mortality in chronic kidney disease. • Electrocardiography has significant advantages in demonstrating cardiac functions in children because it is readily available, non-invasive and often non-experts can interpret the results. What is New: • The heart rate is higher, QTc is longer and QTcD is higher in dialysis patients and the prolonged QTc is more frequent in patients with underlying glomerular diseases. • Left ventricular hypertrophy is more common in HD patients and those with hypertension, hypercalcemia, anemia or glomerular etiology. The cardiovascular risky conditions are less frequent in the patients with kidney transplantation.

Performance of high-sensitivity cardiac troponin T in predicting major cardiovascular events in patients admitted to the emergency department for syncope with normal ECG: An observational prospective study

IntroductionHistory of syncope, clinical examination and electrocardiographic (ECG) findings are fundamental to assess the risk of major cardiovascular events (MACE) in patients attending the emergency department (ED) for syncope. However, in the absence of abnormal clinical examination findings or an abnormal ECG in the ED, transient rhythm or conduction disorders may not be safely excluded, hence predicting MACE remains challenging. High-sensitivity cardiac troponin T (hs-cTnT) may be a useful tool in this context. AimThe primary objective was to evaluate the performance of hs-cTnT in the diagnosis of MACE at 30 days in patients attending the ED for syncope with a normal initial ECG. MethodsThis was a prospective observational cohort study that took place in the ED of a French university hospital between June 2018 and June 2019. Patients≥18 years admitted to the ED for syncope with a normal ECG were eligible. After receiving verbal consent from patients, the ED physician collected clinical and ECG data and all patients had a blood sample taken that included hs-cTnT measurement. The primary outcome was MACE within 30 days after the ED visit. MACE were evaluated by consulting the patient's medical records and telephoning patients or their general practitioners. Sensitivity, specificity, positive and negative predictive values were calculated with their 95% confidence intervals (CI) for different hs-cTnT thresholds. ResultsData from 246 patients were analysed, including 21 (9%) with MACE. Hs-cTnT had an area under the curve of 0.917 (CI: 0.872–0.962). Hs-cTnT with a threshold of 19ng/L had a sensitivity of 86% (CI: 64–97) and a specificity of 86% (CI: 81–90) for predicting MACE. ConclusionHs-cTnT may be a relevant tool for assessing MACE risk in patients with syncope and normal ECG results.