Simple Electrocardiographic Score Can Predict Left Ventricular Reverse Remodeling in Patients With Non-Ischemic Cardiomyopathy

• Published in: Circulation Reports Vol. 1; no. 4; pp. 171 - 178
• Main Authors: Tsukamoto, Yasumasa, Hikoso, Shungo, Miyawaki, Hiroshi, Konishi, Shozo, Sakata, Yasushi, Chimura, Misato, Higuchi, Rie, Ohtani, Tomohito, Sera, Fusako, Nakamoto, Kei, Kanzaki, Machiko, Sengoku, Kaoruko, Mizuno, Hiroya
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 10.04.2019
• Subjects: Cardiomyopathy; Electrocardiography; Heart Failure; Original article; Reverse remodeling; Electrocardiography; Cardiomyopathy; Reverse remodeling
• ISSN: 2434-0790; 2434-0790
• DOI: 10.1253/circrep.CR-19-0005

Background: Left ventricular reverse remodeling (LVRR) is a favorable response in non-ischemic, non-valvular cardiomyopathy (NICM) patients. Recently, 18-lead body surface electrocardiography (ECG), the standard 12-lead ECG with synthesized right-sided/posterior chest leads, has been developed, but its predictive value for LVRR has not been evaluated. Methods and Results: Of 216 consecutive hospitalized NICM patients with LV ejection fraction (LVEF) ≤35%, we studied 125 who received optimization of their heart failure treatment and had 18-lead ECG and echocardiography data available for evaluating LVRR, defined as an absolute increase in LVEF ≥10% concomitant with LVEF ≥35% after 1-year optimized treatment. Most 18-lead ECG parameters in the NICM patients differed from those in 312 age- and body mass index-matched subjects with normal echocardiography. LVRR occurred in 59 NICM patients and they had a larger QRS amplitude in the limb leads (I, II, aVR, and aVF), precordial leads (V3–V6), and synthesized leads (syn-V4R–5R), decreased QRS axis and duration, and lower prevalence of fragmented QRS than those without LVRR. The ECG score using 3 selected parameters (QRS amplitude in aVR ≥675 µV; QRS duration <106 ms without fragmentation; and QRS axis <67°) was associated with the incidence of LVRR even after adjusting for optimized treatment. Conclusions: The standard 12-lead ECG parameters are sufficiently predictive of LVRR in NICM patients.