Electrocardiographic strain pattern in children with left ventricular hypertrophy: A marker of ventricular dysfunction

Nishant Shah, Kavitha Chintala, Sanjeev Aggarwal

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

The objective of this study was to assess the relation between strain pattern on electrocardiogram (ECG-strain) and echocardiographic indices of left ventricular (LV) structure and function in children with LV hypertrophy (LVH). ECG-strain is a marker of LVH and is associated with adverse cardiovascular prognosis in adults. The significance of ECG-strain and its relation to LV structure and function has not been studied in children. We retrospectively analyzed electrocardiograms (ECGs) and echocardiograms of 101 children enrolled in this study. Subjects were divided into three groups: group I (n = 21) comprised children with LVH confirmed by echocardiography (LVHecho) with ECG-strain pattern; group II (n = 54) comprised children with LVH echo without ECG-strain pattern; and group III (n = 26) comprised children without LVH (control group). ECG-strain was defined as a down-sloping convex ST-segment depression (≥0.1 mV) with an inverted asymmetrical T-wave opposite to the QRS axis in leads V5 and/or V6. LV structure and function was measured using conventional and tissue Doppler echocardiography. ECG-strain was associated with greater interventricular septal thickness, posterior wall thickness, and LV mass index (LVMI) compared with those without ECG-strain (P < 0.0001 for each variable). Concentric LVH was more common in those with ECG-strain (16 of 21 vs. 9 of 54 patients; P = < 0.0001). ECG-strain was associated with systolic, diastolic, and combined systolic-diastolic dysfunction in children with LVHecho. Among children with LVH, ECG-strain is associated with higher LVMI, concentric pattern of LVH, and LV systolic and diastolic dysfunction. Whether this has similar adverse prognostic implications as it does in adults remains to be determined.

Original languageEnglish (US)
Pages (from-to)800-806
Number of pages7
JournalPediatric Cardiology
Volume31
Issue number6
DOIs
StatePublished - Aug 2010

Fingerprint

Ventricular Dysfunction
Left Ventricular Hypertrophy
Electrocardiography
Hypertrophy
Left Ventricular Function
Echocardiography
Doppler Echocardiography

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

Shah, Nishant ; Chintala, Kavitha ; Aggarwal, Sanjeev. / Electrocardiographic strain pattern in children with left ventricular hypertrophy : A marker of ventricular dysfunction. In: Pediatric Cardiology. 2010 ; Vol. 31, No. 6. pp. 800-806.
@article{64762aa7bc784da087c1c3d1ca71c7d6,
title = "Electrocardiographic strain pattern in children with left ventricular hypertrophy: A marker of ventricular dysfunction",
abstract = "The objective of this study was to assess the relation between strain pattern on electrocardiogram (ECG-strain) and echocardiographic indices of left ventricular (LV) structure and function in children with LV hypertrophy (LVH). ECG-strain is a marker of LVH and is associated with adverse cardiovascular prognosis in adults. The significance of ECG-strain and its relation to LV structure and function has not been studied in children. We retrospectively analyzed electrocardiograms (ECGs) and echocardiograms of 101 children enrolled in this study. Subjects were divided into three groups: group I (n = 21) comprised children with LVH confirmed by echocardiography (LVHecho) with ECG-strain pattern; group II (n = 54) comprised children with LVH echo without ECG-strain pattern; and group III (n = 26) comprised children without LVH (control group). ECG-strain was defined as a down-sloping convex ST-segment depression (≥0.1 mV) with an inverted asymmetrical T-wave opposite to the QRS axis in leads V5 and/or V6. LV structure and function was measured using conventional and tissue Doppler echocardiography. ECG-strain was associated with greater interventricular septal thickness, posterior wall thickness, and LV mass index (LVMI) compared with those without ECG-strain (P < 0.0001 for each variable). Concentric LVH was more common in those with ECG-strain (16 of 21 vs. 9 of 54 patients; P = < 0.0001). ECG-strain was associated with systolic, diastolic, and combined systolic-diastolic dysfunction in children with LVHecho. Among children with LVH, ECG-strain is associated with higher LVMI, concentric pattern of LVH, and LV systolic and diastolic dysfunction. Whether this has similar adverse prognostic implications as it does in adults remains to be determined.",
author = "Nishant Shah and Kavitha Chintala and Sanjeev Aggarwal",
year = "2010",
month = "8",
doi = "10.1007/s00246-010-9707-8",
language = "English (US)",
volume = "31",
pages = "800--806",
journal = "Pediatric Cardiology",
issn = "0172-0643",
publisher = "Springer New York",
number = "6",

}

Electrocardiographic strain pattern in children with left ventricular hypertrophy : A marker of ventricular dysfunction. / Shah, Nishant; Chintala, Kavitha; Aggarwal, Sanjeev.

In: Pediatric Cardiology, Vol. 31, No. 6, 08.2010, p. 800-806.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Electrocardiographic strain pattern in children with left ventricular hypertrophy

T2 - A marker of ventricular dysfunction

AU - Shah, Nishant

AU - Chintala, Kavitha

AU - Aggarwal, Sanjeev

PY - 2010/8

Y1 - 2010/8

N2 - The objective of this study was to assess the relation between strain pattern on electrocardiogram (ECG-strain) and echocardiographic indices of left ventricular (LV) structure and function in children with LV hypertrophy (LVH). ECG-strain is a marker of LVH and is associated with adverse cardiovascular prognosis in adults. The significance of ECG-strain and its relation to LV structure and function has not been studied in children. We retrospectively analyzed electrocardiograms (ECGs) and echocardiograms of 101 children enrolled in this study. Subjects were divided into three groups: group I (n = 21) comprised children with LVH confirmed by echocardiography (LVHecho) with ECG-strain pattern; group II (n = 54) comprised children with LVH echo without ECG-strain pattern; and group III (n = 26) comprised children without LVH (control group). ECG-strain was defined as a down-sloping convex ST-segment depression (≥0.1 mV) with an inverted asymmetrical T-wave opposite to the QRS axis in leads V5 and/or V6. LV structure and function was measured using conventional and tissue Doppler echocardiography. ECG-strain was associated with greater interventricular septal thickness, posterior wall thickness, and LV mass index (LVMI) compared with those without ECG-strain (P < 0.0001 for each variable). Concentric LVH was more common in those with ECG-strain (16 of 21 vs. 9 of 54 patients; P = < 0.0001). ECG-strain was associated with systolic, diastolic, and combined systolic-diastolic dysfunction in children with LVHecho. Among children with LVH, ECG-strain is associated with higher LVMI, concentric pattern of LVH, and LV systolic and diastolic dysfunction. Whether this has similar adverse prognostic implications as it does in adults remains to be determined.

AB - The objective of this study was to assess the relation between strain pattern on electrocardiogram (ECG-strain) and echocardiographic indices of left ventricular (LV) structure and function in children with LV hypertrophy (LVH). ECG-strain is a marker of LVH and is associated with adverse cardiovascular prognosis in adults. The significance of ECG-strain and its relation to LV structure and function has not been studied in children. We retrospectively analyzed electrocardiograms (ECGs) and echocardiograms of 101 children enrolled in this study. Subjects were divided into three groups: group I (n = 21) comprised children with LVH confirmed by echocardiography (LVHecho) with ECG-strain pattern; group II (n = 54) comprised children with LVH echo without ECG-strain pattern; and group III (n = 26) comprised children without LVH (control group). ECG-strain was defined as a down-sloping convex ST-segment depression (≥0.1 mV) with an inverted asymmetrical T-wave opposite to the QRS axis in leads V5 and/or V6. LV structure and function was measured using conventional and tissue Doppler echocardiography. ECG-strain was associated with greater interventricular septal thickness, posterior wall thickness, and LV mass index (LVMI) compared with those without ECG-strain (P < 0.0001 for each variable). Concentric LVH was more common in those with ECG-strain (16 of 21 vs. 9 of 54 patients; P = < 0.0001). ECG-strain was associated with systolic, diastolic, and combined systolic-diastolic dysfunction in children with LVHecho. Among children with LVH, ECG-strain is associated with higher LVMI, concentric pattern of LVH, and LV systolic and diastolic dysfunction. Whether this has similar adverse prognostic implications as it does in adults remains to be determined.

UR - http://www.scopus.com/inward/record.url?scp=77955526864&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77955526864&partnerID=8YFLogxK

U2 - 10.1007/s00246-010-9707-8

DO - 10.1007/s00246-010-9707-8

M3 - Article

C2 - 20422173

AN - SCOPUS:77955526864

VL - 31

SP - 800

EP - 806

JO - Pediatric Cardiology

JF - Pediatric Cardiology

SN - 0172-0643

IS - 6

ER -