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Utility of QRS isointegral maps in Left ventricular hypertrophy


Cardiac hypertrophy is an increase in the mass of the heart because of the enlargement of existing muscle fibres. It can be diagnosed in different ways including electrocardiographic body surface mapping. The aim of this paper is to give a brief qualitative and quantitative overview of the QRS isointegral maps in the left ventricular hypertrophy based on our original results as well as on published results. Electrocardiograms were recorded and QRS isointegral maps were constructed using the 24-lead system after Barr in different groups of patients with hypertension and patients with echocardiographically established left ventricular hypertrophy. Values of patients´ map extrema were compared with those of control subjects without cardiovascular diseases and also correlated with selected echocardiographic parameters. Increased as well as decreased values of extrema were found in patients compared to controls. Several extrema correlated well with left ventricular echocardiographic dimensions. In our studies, we found no significant changes of the QRS complex between controls and patients, although the peak-to-peak values increased with increasing left ventricular mass. This is in good agreement with some published data obtained with different lead systems. The disagreement in the results of other papers could be caused by differently defined groups of patients, a different aetiology of hypertrophy, racial differences, the possible influence of obesity, sex, and/or age. Despite these facts, considering both anatomical and electrical remodelling in the left ventricular hypertrophy, electrocardiographic body surface mapping is a useful method for the evaluation of such patients. The obtained detailed information can be valuable in understanding electrophysiological changes and consequences in left ventricular hypertrophy, and current clinical management of patients.

Keywords:
body surface potential mapping, isointegral map, QRS complex, hypertension, left ventricular hypertrophy


Autoři: Katarína Kozlíková
Působiště autorů: Medical Faculty of Comenius University in Bratislava, Bratislava, SR ;  Institute of Medical Physics, Biophysics, Informatics and Telemedicine
Vyšlo v časopise: Lékař a technika - Clinician and Technology No. 1, 2015, 45, 21-26
Kategorie: Původní práce

Souhrn

Cardiac hypertrophy is an increase in the mass of the heart because of the enlargement of existing muscle fibres. It can be diagnosed in different ways including electrocardiographic body surface mapping. The aim of this paper is to give a brief qualitative and quantitative overview of the QRS isointegral maps in the left ventricular hypertrophy based on our original results as well as on published results. Electrocardiograms were recorded and QRS isointegral maps were constructed using the 24-lead system after Barr in different groups of patients with hypertension and patients with echocardiographically established left ventricular hypertrophy. Values of patients´ map extrema were compared with those of control subjects without cardiovascular diseases and also correlated with selected echocardiographic parameters. Increased as well as decreased values of extrema were found in patients compared to controls. Several extrema correlated well with left ventricular echocardiographic dimensions. In our studies, we found no significant changes of the QRS complex between controls and patients, although the peak-to-peak values increased with increasing left ventricular mass. This is in good agreement with some published data obtained with different lead systems. The disagreement in the results of other papers could be caused by differently defined groups of patients, a different aetiology of hypertrophy, racial differences, the possible influence of obesity, sex, and/or age. Despite these facts, considering both anatomical and electrical remodelling in the left ventricular hypertrophy, electrocardiographic body surface mapping is a useful method for the evaluation of such patients. The obtained detailed information can be valuable in understanding electrophysiological changes and consequences in left ventricular hypertrophy, and current clinical management of patients.

Keywords:
body surface potential mapping, isointegral map, QRS complex, hypertension, left ventricular hypertrophy


Zdroje

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[16] Mosteller, R. D. Simplified Calculation of Body Surface Area. New England Journal of Medicine, 1987, vol. 317, no. 17, p. 1098.

[17] Mozos, I., Hancu, M., Jost, N. Isointegral body surface maps and left ventricular hypertrophy in post-infarction heart failure patients. Acta Physiologica Hungarica, 2012, vol. 99, no. 1, p. 19–24.

[18] Oikarinen, L., Karvonen, M., Viitasalo, M. et al. Electrocardiographic assessment of left ventricular hyper-trophy with time-voltage QRS and QRST-wave areas. Journal of Human Hypertension, 2004; vol. 18, no. 1, p 33–40.

[19] Okin, P. M., Roman, M. J., Devereux, R. B. et al. Time-voltage QRS area of the 12-lead electrocardiogram. Detection of left ventricular hypertrophy. Hypertension 1998; 31(4): 937–942.

[20] Sobieszczanska, M., Kalka, D., Jagielski, J. et al. QRS isointegral maps in a follow-up of the patients with hypertensive left ventricular hypertrophy. In: Hiraoka, M., Ogawa, S., Kodama, I. et al. (Eds.) Advances in Electrocardiology. World Scientific, New Jersey, 2004, p. 544–547. ISBN 981-256-107-2.

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