Evidence map›Paper›PMID 41066057›Full record

ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2026

The spatial ventricular gradient is a non-invasive, vectorcardiographic correlate of cardiac fibrosis.

Hans F Stabenau, Jason D Matos, Daniel B Kramer, Arunashis Sau, Libor Pastika, Ewa Sieliwonczyk, Konstantinos Patlatzoglou, Nicholas S Peters, Patricia Tung, Fu Siong Ng and 2 more

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Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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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

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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

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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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

12 authors.

Hans F StabenauDivision of Electrophysiology, Harvard-Thorndike Arrhythmia Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Jason D MatosDepartment of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Daniel B KramerDivision of Electrophysiology, Harvard-Thorndike Arrhythmia Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Arunashis SauNational Heart and Lung Institute, Imperial College London, London, UK.
Libor PastikaNational Heart and Lung Institute, Imperial College London, London, UK.
Ewa SieliwonczykNational Heart and Lung Institute, Imperial College London, London, UK.
Konstantinos PatlatzoglouNational Heart and Lung Institute, Imperial College London, London, UK.
Nicholas S PetersNational Heart and Lung Institute, Imperial College London, London, UK.
Patricia TungDivision of Electrophysiology, Harvard-Thorndike Arrhythmia Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Fu Siong NgNational Heart and Lung Institute, Imperial College London, London, UK.
Reza NezafatDepartment of Medicine (Cardiovascular Division) and Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Jonathan W WaksDivision of Electrophysiology, Harvard-Thorndike Arrhythmia Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. jwaks@bidmc.harvard.edu.ORCID http://orcid.org/0000-0001-5560-5638

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiac MRI (CMR) markers of myocardial fibrosis and infiltration are diagnostically and prognostically important in cardiomyopathies. A noninvasive ECG correlate of CMR interstitial fibrosis measurements (extracellular volume [ECV] and native T1) could assist in diagnosis, risk stratification, and tracking disease progress. The spatial ventricular gradient (SVG) is a vectorcardiographic (VCG) measure of electrical heterogeneity obtained from a 12-lead ECG. The link between the SVG and CMR-derived myocardial interstitial fibrosis is unknown.

methodsRetrospective study of patients referred for CMR from 2018-2022 at a single academic center, with an ECG performed within 30 days. VCGs were constructed from 12-lead ECGs, and SVG vector components were calculated. ECV and T1 values were regressed on SVG components, demographics, and ECG parameters using linear regression.

resultsIn total, 345 patients met inclusion criteria: 55% male, median age 60.2 (P25-P75 47.4-69.9) years, and median LVEF 57 (P25-P75 44-63)%. Median SVG magnitude was 39.5 (P25-P75 28.2-58.2) mV∙ms and SVG magnitude was inversely correlated with ECV and T1 (p < 0.001 for both). In a multivariable model, SVG magnitude remained independently associated with ECV and T1 after adjustment for body mass index, LVEF, age, and sex (p < 0.01). Patients with amyloid cardiomyopathy had the most abnormal values of ECV and T1; no amyloid patient had SVG magnitude > 50 mV∙ms.

conclusionSVG magnitude is correlated with CMR-derived ECV and native T1. Patients with high SVG magnitude were not observed to have a large burden of diffuse fibrosis or infiltration.

Indexed as

CardiomyopathiesVectorcardiographyAgedElectrocardiographyFemaleFibrosisHumansMagnetic Resonance Imaging, CineMaleMiddle AgedRetrospective StudiesCardiac MRIExtracellular volumeFibrosisSpatial ventricular gradientVectorcardiogram

Identifiers

PMID41066057

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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.