Heart failure & cardiomyopathies
Novel Electrocardiographic Criteria May Render Possible the More Accurate Recognition of Cardiac Amyloidosis
Authors' conclusion
The novel ECG criteria [mostly the aVR < 0.5, (I + aVR)/(V1-4) < 0.375] seem at least as reliable in the diagnosis of CA as the best echocardiographic myocardial deformation criteria
Study context
- Population
- 34 patients with confirmed cardiac amyloidosis (CA) (20 transthyretin, 14 AL) and 45 controls with LV hypertrophy on echocardiography (hypertension, valvular AS, hypertrophic cardiomyopathy)34 CA, 45 controls
- Comparison
- Five novel electrocardiographic (ECG) criteria for CA vs LV hypertrophy controls
- Outcome
- Diagnostic accuracy of novel ECG criteria for CA
Performance
As reported in the abstract
Diagnostic performance for CA
| Strategy | AUC | Sensitivity | Specificity | PPV | NPV | Test accuracy |
|---|---|---|---|---|---|---|
| I < 0.55 | 0.8922 | 76.5% | 84.4% | 78.8% | 82.6% | 81% |
| aVR < 0.5 | 0.8794 | 82.4% | 86.7% | 82.4% | 86.7% | 84.8% |
| (I + aVR) < 0.575 | 09016 | 85.3% | 80% | 76.3% | 87.8% | 82.3% |
| (I + aVR)/(V1-4) < 0.375 | 0.8824 | 82.4% | 86.7% | 82.4% | 86.7% | 84.8% |
| (I + aVR)/I,aVL,V1-6ID < 0.0115 | 0.8462 | 76.9% | 87.5% | 80% | 85.4% | 83.3% |
AUC
I < 0.550.8922
aVR < 0.50.8794
(I + aVR) < 0.57509016
(I + aVR)/(V1-4) < 0.3750.8824
(I + aVR)/I,aVL,V1-6ID < 0.01150.8462
Sensitivity
I < 0.5576.5%
aVR < 0.582.4%
(I + aVR) < 0.57585.3%
(I + aVR)/(V1-4) < 0.37582.4%
(I + aVR)/I,aVL,V1-6ID < 0.011576.9%
Specificity
I < 0.5584.4%
aVR < 0.586.7%
(I + aVR) < 0.57580%
(I + aVR)/(V1-4) < 0.37586.7%
(I + aVR)/I,aVL,V1-6ID < 0.011587.5%
PPV
I < 0.5578.8%
aVR < 0.582.4%
(I + aVR) < 0.57576.3%
(I + aVR)/(V1-4) < 0.37582.4%
(I + aVR)/I,aVL,V1-6ID < 0.011580%
NPV
I < 0.5582.6%
aVR < 0.586.7%
(I + aVR) < 0.57587.8%
(I + aVR)/(V1-4) < 0.37586.7%
(I + aVR)/I,aVL,V1-6ID < 0.011585.4%
Test accuracy
I < 0.5581%
aVR < 0.584.8%
(I + aVR) < 0.57582.3%
(I + aVR)/(V1-4) < 0.37584.8%
(I + aVR)/I,aVL,V1-6ID < 0.011583.3%
Further findings
Classical criterion: low voltage in limb leads
- Present in CA
- 73.5%
- Test accuracy
- 78.5%
- Sensitivity
- 73.5%
- Specificity
- 82.2%
- PPV
- 75.8%
- NPV
- 80.4%
- Slightly worse diagnostic value than the novel ECG criteria
Original publication
Novel Electrocardiographic Criteria May Render Possible the More Accurate Recognition of Cardiac Amyloidosis. ESC Heart Fail. Published 19 January 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →