Accuracy of Electrocardiography and Agreement with Echocardiography in the Diagnosis of Pediatric Left Atrial Enlargement
| Autor: | Dalton R. Budhram, Charis Ng, Tapas Mondal, Attila Ahmad, Mu He, Narayanaswamy Balakrishnan |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Diastole Cardiology lcsh:Medicine Cardiomegaly 030204 cardiovascular system & hematology Paediatric research 01 natural sciences Sensitivity and Specificity Article 010104 statistics & probability 03 medical and health sciences Electrocardiography 0302 clinical medicine Cohen's kappa Left atrial Internal medicine medicine Left atrial enlargement Humans In patient cardiovascular diseases Heart Atria 0101 mathematics PR interval lcsh:Science Child Retrospective Studies Multidisciplinary Receiver operating characteristic medicine.diagnostic_test business.industry lcsh:R Infant Newborn Infant Reproducibility of Results medicine.disease Echocardiography Child Preschool cardiovascular system lcsh:Q Atrial Function Left Female business |
| Zdroj: | Scientific Reports Scientific Reports, Vol 10, Iss 1, Pp 1-8 (2020) |
| ISSN: | 2045-2322 |
| Popis: | Left atrial enlargement (LAE) is a marker for diastolic cardiac dysfunction. Echocardiograms are considered the gold-standard for diagnosis, but given their wider access and lower economic cost, electrocardiograms (ECGs) may be useful in identifying patients who would benefit from further investigation. This study investigates the utility of ECG criteria to diagnose LAE in pediatric patients. A retrospective chart review (n = 492) was conducted in patients whose echocardiograms demonstrated LAE by left atrial indexed diameter z-score ≥2.0 and/or increased left atrial to aortic root ratio at various cutoffs (≥1.4, ≥1.6, ≥1.8). ECG criteria studied included: (1) P wave ≥110 msec, (2) P mitrale ≥40 msec, in LII (3) terminal negative P wave deflection in lead V1 > 40 msec, and (4) P/PR segment >1.6 in lead II. Sensitivity, specificity, Cohen’s Kappa coefficient (κ), and ROC curves were calculated. A combination of P mitrale ≥40 msec and terminal negative P wave deflection in lead V1 > 40 msec yielded the greatest agreement (κ = 0.221, 95%CI 0.060–0.382), but all ECG criteria used to diagnose LAE had poor diagnostic value (AUC |
| Databáze: | OpenAIRE |
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