Diagnostic value of P-waves in children with idiopathic restrictive cardiomyopathy
- 26 January 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Heart and Vessels
- Vol. 36 (8), 1-10
- https://doi.org/10.1007/s00380-021-01784-4
Abstract
Restrictive cardiomyopathy (RCM) is a rare myocardial disease with an impaired diastolic function and poor prognosis. Almost all RCM patients are reported to have abnormal P-waves due to atrial overloading. This study aimed to reveal the characteristics of the P-waves in RCM patients and to suggest the diagnostic index of RCM in children with a 12-lead electrocardiogram (ECG). We retrospectively investigated 17 ECGs of children with idiopathic RCM during the initial visit at 15 institutes in Japan between 1979 and 2013. The RCM group was divided into four groups based on the age (elementary school [ES] and junior high school [JHS] students) and inception of the diagnosis (abnormal ECG on school-heart-screening [e-RCM] and some cardiovascular symptoms [s-RCM]), the ES/e-RCM (n = 5), ES/s-RCM (n = 4), JHS/e-RCM (n = 4), and JHS/s-RCM (n = 4) groups. As an aged-match control group, school-heart-screening ECGs of 1st-grade ES students (16,770 students) and 1st-grade JHS students (18,126 students) from Kagoshima in 2016 were adopted. For a comparison between the groups, we used the effect size “Hedge’s g” by calculating the mean and standard deviation of the two groups. An effect size of 0.8 (or above) had an overlap of 53% (or less). The effect sizes of the sum of the absolute values of the forward and backward amplitudes in lead V1 (P1 + P2 V1) was the largest, and the ES/e-RCM, ES/s-RCM, JHS/e-RCM, and JHS/s-RCM were 15.8, 22.1, 9.4, and 10.3, respectively. A P1 + P2 V1 > 200 μV was able to rule in all RCM patients, thus, we proposed 200 µV as the cutoff value for screening purposes. In conclusion, the P1 + P2 V1 in the school-heart-screening may be useful for detecting asymptomatic or early-stage RCM in school-age children.Keywords
This publication has 33 references indexed in Scilit:
- The Cardiomyopathy Registry of the EURObservational Research Programme of the European Society of Cardiology: baseline data and contemporary management of adult patients with cardiomyopathiesEuropean Heart Journal, 2018
- Outcomes of Children With Restrictive Cardiomyopathy Listed for Heart Transplant: A Multi-institutional StudyThe Journal of Heart and Lung Transplantation, 2009
- Classification of the cardiomyopathies: a position statement from the european society of cardiology working group on myocardial and pericardial diseasesEuropean Heart Journal, 2007
- Idiopathic restrictive cardiomyopathy in childrenHeart, 2005
- Outcome of idiopathic restrictive cardiomyopathy in childrenThe American Journal of Cardiology, 2002
- Clinical spectrum of restrictive cardiomyopathy in childrenThe Journal of Heart and Lung Transplantation, 2001
- Sudden Death and Cardiovascular Collapse in Children With Restrictive CardiomyopathyCirculation, 2000
- Epidemiology of Idiopathic Cardiomyopathies in Children and Adolescents: A Nationwide Study in FinlandAmerican Journal of Epidemiology, 1997
- Idiopathic Restrictive Cardiomyopathy in Childhood: Diagnostic Features and Clinical CourseMayo Clinic Proceedings, 1995
- Clinical profile and outcome of restrictive cardiomyopathy in childrenAmerican Heart Journal, 1992