Observational studyJournal of the American Heart Association2015
Clinical Utility of Ventricular Repolarization Dispersion for Real-Time Detection of Non-ST Elevation Myocardial Infarction in Emergency Departments.
Observational study in Journal of the American Heart Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
14 citing papers in PubMed, 26 citations in OpenAlex.
- Review
- Machine learning for ECG diagnosis and risk stratification of occlusion myocardial infarction.Nature medicine · 2023Observational
- Regional beat-to-beat variability of repolarization increases during ischemia and predicts imminent arrhythmias in a pig model of myocardial infarction.American journal of physiology. Heart and circulatory physiology · 2023Article
- Machine Learning for the ECG Diagnosis and Risk Stratification of Occlusion Myocardial Infarction at First Medical Contact.Research square · 2023Article
- Incorporation of Serial 12-Lead Electrocardiogram With Machine Learning to Augment the Out-of-Hospital Diagnosis of Non-ST Elevation Acute Coronary Syndrome.Annals of emergency medicine · 2023Observational
- Automated Detection of Acute Myocardial Infarction Using Asynchronous Electrocardiogram Signals-Preview of Implementing Artificial Intelligence With Multichannel Electrocardiographs Obtained From Smartwatches: Retrospective Study.Journal of medical Internet research · 2021Article
- In Search of an Optimal Subset of ECG Features to Augment the Diagnosis of Acute Coronary Syndrome at the Emergency Department.Journal of the American Heart Association · 2021Observational
- Machine learning-based prediction of acute coronary syndrome using only the pre-hospital 12-lead electrocardiogram.Nature communications · 2020Article
- Comparison of clinical risk scores for triaging high-risk chest pain patients at the emergency department.The American journal of emergency medicine · 2019Article
- Spatial indices of repolarization correlate with non-ST elevation myocardial ischemia in patients with chest pain.Medical & biological engineering & computing · 2018Article
- Non-ST-Segment Elevation Myocardial Infarction: A Novel and Robust Approach for Early Detection of Patients at Risk.Journal of the American Heart Association · 2015Article
- Evaluation of beat-to-beat ventricular repolarization lability from standard 12-lead ECG during acute myocardial ischemia.Journal of electrocardiologyObservational
- Emerging ECG methods for acute coronary syndrome detection: Recommendations & future opportunities.Journal of electrocardiologyArticle
- Novel ECG features and machine learning to optimize culprit lesion detection in patients with suspected acute coronary syndrome.Journal of electrocardiologyObservational
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundA specific electrocardiographic (ECG) marker of ischemia would greatly improve the speed and accuracy of detecting and treating non-ST elevation myocardial infarction (NSTEMI). We hypothesize that ischemia induces ventricular repolarization dispersion (VRD), altering the T-wave before any ST segment deviation. We sought to evaluate the clinical utility of VRD to (1) detect NSTEMI cases in the emergency department (ED) and (2) identify NSTEMI cases at high risk for in-hospital major adverse cardiac events (MACEs). METHODS AND
resultsWe continuously recorded 12-lead Holter ECGs from chest pain patients upon their arrival to the ED. VRD was quantified using principal component analysis of the 12-lead ECG to compute a T-wave complexity ratio (ie, ratio of second to first eigenvectors of repolarization). Clinical outcomes were obtained from hospital records. The sample was composed mainly of older males (n=369; ages 63±12 years; 63% males), and 92 (25%) had NSTEMI and 26 (7%) had MACEs. Baseline T-wave complexity ratio modestly correlated with peak troponin levels (r=0.41; P<0.001) and was a good classifier of NSTEMI events (area under the curve=0.70). An increased T-wave complexity ratio on the presenting ECG was strongly associated with NSTEMI (odds ratio [OR]=3.8 [2.1 to 5.8]) and in-hospital MACE (OR=8.2 [3.1 to 21.5]).
conclusionsA simple measure of global VRD on the presenting 12-lead ECG correlates with ischemic myocardial injury and can discriminate NSTEMI cases very early during evaluation. Prospective studies should validate these findings and test whether VRD can guide therapy.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.