Electrocardiographic Diagnosis of Hypertrophic Cardiomyopathy in the Pre- And Post-Diagnostic Phases in Children and Adolescents

Masao Yoshinaga, Hitoshi Horigome, Mamoru Ayusawa, Kazushi Yasuda, Shigetoyo Kogaki, Shozaburo Doi, Sigeru Tateno, Kunio Ohta, Tatsunori Hokosaki, Eiki Nishihara, Mari Iwamoto, Naokata Sumitomo, Hiroya Ushinohama, Naomi Izumida, Nobuo Tauchi, Yoshiaki Kato, Taichi Kato, Toshiyuki Chisaka, Takashi Higaki, Tatsuya YoneyamaKatsumi Abe, Yoshihiro Nozaki, Akiko Komori, Satoru Kawai, Yumiko Ninomiya, Yuji Tanaka, Norihito Nuruki, Masahiro Sonoda, Kentaro Ueno, Daisuke Hazeki, Yuichi Nomura, Seiichi Sato, Keiichi Hirono, Susumu Hosokawa, Fumie Takechi, Yuichi Ishikawa, Tadayoshi Hata, Fukiko Ichida, Seiko Ohno, Naomasa Makita, Minoru Horie, Shouji Matsushima, Hiroyuki Tsutsui, Hiromitsu Ogata, Hideto Takahashi, Masami Nagashima

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background: The usefulness of electrocardiographic (ECG) voltage criteria for diagnosing hypertrophic cardiomyopathy (HCM) in pediatric patients is poorly defined. Methods and Results: ECGs at the 1st grade (mean [±SD] age 6.6±0.3 years) were available for 11 patients diagnosed with HCM at around the 7th grade (13.2±0.3 years). ECGs were available for another 64 patients diagnosed with HCM in the 1st (n=15), 7th (n=32), and 10th (n=17) grades. Fifty-one voltage criteria were developed by grade and sex using 62,841 ECGs from the general population. Voltage criteria were set at the 99.95th percentile (1/2,000) point based on the estimated prevalence of childhood HCM (2.9 per 100,000 [1/34,483]) to decrease false negatives. Conventional criteria were from guidelines for school-aged children in Japan. Of 11 patients before diagnosis, 2 satisfied conventional criteria in 1st grade; 5 (56%) of the remaining 9 patients fulfilled 2 voltage criteria (R wave in limb-lead I [RI]+S wave in lead V3 [SV3] and R wave in lead V3 [RV3]+SV3). Robustness analysis for sensitivity showed RV3+SV3 was superior to RI+SV3. For all patients after diagnosis, RI+SV4 was the main candidate. However, conventional criteria were more useful than voltage criteria. Conclusions: Early HCM prediction was possible using RV3+SV3 in >50% of patients in 1st grade. Voltage criteria may help diagnose prediagnostic or early HCM, and prevent tragic accidents, although further prospective studies are required.

Original languageEnglish
Pages (from-to)118-127
Number of pages10
JournalCirculation Journal
Volume86
Issue number1
DOIs
Publication statusPublished - 2022

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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