Evidence map›Paper›PMID 27265641›Full record

Observational studyAnnals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc2017

Dynamic Changes in High-Sensitivity Cardiac Troponin I Are Associated with Dynamic Changes in Sum Absolute QRST Integral on Surface Electrocardiogram in Acute Decompensated Heart Failure.

Larisa G Tereshchenko, Albert Feeny, Erica Shelton, Thomas Metkus, Andrew Stolbach, Ernest Mavunga, Shannon Putman, Frederick K Korley

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.1field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Larisa G TereshchenkoThe Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA.
Albert FeenyWhiting School of Engineering, The Johns Hopkins University, Baltimore, MD, USA.
Erica SheltonThe Emergency Medicine Department, Johns Hopkins Hospital, Baltimore, MD, USA.
Thomas MetkusThe Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA.
Andrew StolbachThe Emergency Medicine Department, Johns Hopkins Hospital, Baltimore, MD, USA.
Ernest MavungaThe Emergency Medicine Department, Johns Hopkins Hospital, Baltimore, MD, USA.
Shannon PutmanThe Emergency Medicine Department, Johns Hopkins Hospital, Baltimore, MD, USA.
Frederick K KorleyDepartment of Emergency Medicine, University of Michigan Health Systems, Ann Arbor, MI, USA.
Johns Hopkins Hospital · USJohns Hopkins University · USMichigan Medicine · US

Funding

PATHOPHYSIOLOGY OF MYOCARDIAL DISEASEST32HL007227 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Chulan Kwon, WENDY S POST · 1985 to 2026
$21.2M
Novel ECG Measures and Risk of Sudden Cardiac DeathR01HL118277 · NHLBI · OREGON HEALTH & SCIENCE UNIVERSITY · PI TERESHCHENKO, LARISA GENNADIEVNA · 2013 to 2016
$1.5M
NHLBI NIH HHS R01 HL118277NHLBI NIH HHS T32 HL007227
6 · The paper itself

Abstract

backgroundA three-dimensional electrocardiographic (ECG) metric, the sum absolute QRST integral (SAI QRST), predicts ventricular arrhythmias in heart failure (HF) patients with implantable cardioverter defibrillator and mechanical response to cardiac resynchronization therapy. We hypothesized that there is an association between patient-specific changes in SAI QRST and myocardial injury as measured by high-sensitivity troponin I (hsTnI).

methodsSum absolute integral QRST on resting 12-lead ECG and hsTnI were measured simultaneously, every 3 hours, and during 12-hour observation period in a prospective cohort of emergency department patients (n = 398; mean age 57.8 ± 13.2 years; 54% female, 64% black), diagnosed with acute coronary syndrome (ACS, n = 28), acutely decompensated HF (acute decompensated heart failure, n = 35), cardiac non-ACS (n = 19), or noncardiac condition (n = 316). Random-effects linear regression analysis assessed the association of SAI QRST and myocardial injury, with adjustment for demographics (age, sex, race), prevalent cardiovascular disease (myocardial infarction, history of revascularization, stroke, and HF), risk factors (diabetes, smoking, hypercholesterolemia, hypertension, and cocaine use), and left bundle branch block.

resultsWithin the entire cohort, SAI QRST decreased by 3 (95%CI -5 to -1) mV*ms every 3 hours. A 10-fold increase in hsTnI was associated with a 7.7 (0.6-14.9) mV*ms increase in SAI QRST. In the subgroup of acutely decompensated HF patients (n = 35), a 10-fold increase in hsTnI was associated with a 61.0 (5.9-116.1) mV*ms increase in SAI QRST.

conclusionPatient-specific time-varying changes in the surface ECG scalar measure of global electrical heterogeneity, as measured by SAI QRST, and in myocardial injury as measured by hsTnI, are independently and directly associated with each other, likely reflecting a common underlying mechanism.

Indexed as

Acute Coronary SyndromeAgedBiomarkersElectrocardiographyFemaleHeart FailureHumansMaleMiddle AgedProspective StudiesSensitivity and SpecificityTroponin IBiomarkersTroponin Iacute heart failureelectrocardiogramhigh-sensitivity troponinremodeling

Identifiers

PMID27265641
PMCPMC5140779
OpenAlexW2412620442

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.