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Erschienen in: Heart and Vessels 8/2020

17.03.2020 | Original Article

Detection of arrhythmogenic substrate within QRS complex in patients with cardiac sarcoidosis using wavelet-transformed ECG

verfasst von: Kenji Yodogawa, Toshihiko Ohara, Hiroshige Murata, Yu-ki Iwasaki, Yoshihiko Seino, Wataru Shimizu

Erschienen in: Heart and Vessels | Ausgabe 8/2020

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Abstract

Signal-averaged electrocardiography (SAECG) has been known to be useful for prediction of lethal ventricular arrhythmias (VA). However, this technique has limitations in patients with intraventricular conduction disturbance (IVCD), which is common in cardiac sarcoidosis (CS). Meanwhile, wavelet-transformed ECG (WTECG) has been reported to be useful for detecting arrhythmogenic substrate hidden within QRS complex. The objective of this study was to assess the utility of WTECG for detecting arrhythmogenic substrate in patients with CS. Forty-four CS patients including 18 patients with VA were retrospectively investigated. The parameters on the signal-averaged electrocardiography (SAECG) and the power of frequency components on WTECG were compared between VA group and non-VA group. Eighteen patients have VA (VT: n = 17, VF: n = 1). LP were detected in 17 in VA group and 24 in non-VA group. WTECG showed that high-frequency components (HFC; 80–150 Hz) were developed in VA group. Peak power value at 150 Hz (P150) was significantly higher in VA group than that in non-VA group (442.9 ± 160.2 vs 316.7 ± 100.8, p = 0.006). The receiver operating characteristic (ROC) curve analysis showed an optimal cutoff point of 336 of P150 for detecting patients with VA, with 82.4% sensitivity, 61.5% specificity, and area under the curve of 0.74 (95% confidence interval [CI] 0.59–0.89). WTECG may be useful for detecting CS patients who are prone to VA.
Literatur
2.
Zurück zum Zitat Iwai K, Tachibana T, Takemura T, Matsui Y, Kitaichi M, Kawabata Y (1993) Pathological studies on sarcoidosis autopsy. I. Epidemiological features of 320 cases in Japan. Acta Pathol Jpn 43:372–376PubMed Iwai K, Tachibana T, Takemura T, Matsui Y, Kitaichi M, Kawabata Y (1993) Pathological studies on sarcoidosis autopsy. I. Epidemiological features of 320 cases in Japan. Acta Pathol Jpn 43:372–376PubMed
3.
Zurück zum Zitat Silverman KJ, Hutchins GM, Buckley BH (1978) Cardiac sarcoid a clinicopathologic study of 84 unselected patients with systemic sarcoidosis. Circulation 58:1204–1211CrossRefPubMed Silverman KJ, Hutchins GM, Buckley BH (1978) Cardiac sarcoid a clinicopathologic study of 84 unselected patients with systemic sarcoidosis. Circulation 58:1204–1211CrossRefPubMed
4.
Zurück zum Zitat Kanovsky MS, Falcone RA, Dresden CA, Josephson ME, Simson MB (1984) Identification of patients with ventricular tachycardia after myocardial infarction: signal-averaged electrocardiogram, Holter monitoring, and cardiac catheterization. Circulation 70:264–270CrossRefPubMed Kanovsky MS, Falcone RA, Dresden CA, Josephson ME, Simson MB (1984) Identification of patients with ventricular tachycardia after myocardial infarction: signal-averaged electrocardiogram, Holter monitoring, and cardiac catheterization. Circulation 70:264–270CrossRefPubMed
5.
Zurück zum Zitat Savard P, Rouleau JL, Ferguson J, Poitras N, Morel P, Davies RF, Stewart DJ, Talajic M, Gardner M, Dupuis R, Lauzon C, Sussex B, Potvin L, Warnica W (1997) Risk stratification after myocardial infarction using signal-averaged electrocardiographic criteria adjusted for sex, age, and myocardial infarction location. Circulation 96:202–213CrossRefPubMed Savard P, Rouleau JL, Ferguson J, Poitras N, Morel P, Davies RF, Stewart DJ, Talajic M, Gardner M, Dupuis R, Lauzon C, Sussex B, Potvin L, Warnica W (1997) Risk stratification after myocardial infarction using signal-averaged electrocardiographic criteria adjusted for sex, age, and myocardial infarction location. Circulation 96:202–213CrossRefPubMed
6.
Zurück zum Zitat Poll DS, Marchilinski FE, Falcone RA, Josephson ME, Simson MB (1985) Abnormal signal-averaged electrocardiograms in patients with nonischemic congestive cardiomyopathy: relationship to sustained ventricular tachyarrhythmias. Circulation 72:1308–1313CrossRefPubMed Poll DS, Marchilinski FE, Falcone RA, Josephson ME, Simson MB (1985) Abnormal signal-averaged electrocardiograms in patients with nonischemic congestive cardiomyopathy: relationship to sustained ventricular tachyarrhythmias. Circulation 72:1308–1313CrossRefPubMed
7.
Zurück zum Zitat Mancini D, Wong KL, Simson MB (1993) Prognostic value of an abnormal signal averaged electrocardiogram in patients with nonischemic congestive cardiomyopathy. Circulation 87:1083–1092CrossRefPubMed Mancini D, Wong KL, Simson MB (1993) Prognostic value of an abnormal signal averaged electrocardiogram in patients with nonischemic congestive cardiomyopathy. Circulation 87:1083–1092CrossRefPubMed
8.
Zurück zum Zitat Yodogawa K, Morita N, Kobayashi Y, Takayama H, Ohara T, Katoh T, Takano T (2006) High-frequency potentials developed in wavelet-transformed electrocardiogram as a novel indicator for detecting Brugada syndrome. Heart Rhythm 3:1436–1444CrossRefPubMed Yodogawa K, Morita N, Kobayashi Y, Takayama H, Ohara T, Katoh T, Takano T (2006) High-frequency potentials developed in wavelet-transformed electrocardiogram as a novel indicator for detecting Brugada syndrome. Heart Rhythm 3:1436–1444CrossRefPubMed
9.
Zurück zum Zitat Tsutsumi T, Takano N, Matsuyama N, Higashi Y, Iwasawa K, Nakajima T (2011) High-frequency powers hidden within QRS complex as an additional predictor of lethal ventricular arrhythmias to ventricular late potential in post-myocardial infarction patients. Heart Rhythm 8:1509–1515CrossRefPubMed Tsutsumi T, Takano N, Matsuyama N, Higashi Y, Iwasawa K, Nakajima T (2011) High-frequency powers hidden within QRS complex as an additional predictor of lethal ventricular arrhythmias to ventricular late potential in post-myocardial infarction patients. Heart Rhythm 8:1509–1515CrossRefPubMed
10.
Zurück zum Zitat Yodogawa K, Morita N, Kobayashi Y, Takayama H, Ohara T, Seino Y, Katoh T, Mizuno K (2011) A new approach for the comparison of conduction abnormality between arrhythmogenic right ventricular cardiomyopathy/dysplasia and Brugada syndrome. Ann Noninvasive Electrocardiol 16:263–269CrossRefPubMedPubMedCentral Yodogawa K, Morita N, Kobayashi Y, Takayama H, Ohara T, Seino Y, Katoh T, Mizuno K (2011) A new approach for the comparison of conduction abnormality between arrhythmogenic right ventricular cardiomyopathy/dysplasia and Brugada syndrome. Ann Noninvasive Electrocardiol 16:263–269CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Yodogawa K, Ohara T, Takayama H, Seino Y, Katoh T, Mizuno K (2011) Detection of prior myocardial infarction patients prone to malignant ventricular arrhythmias using wavelet transform analysis. Int Heart J 52:286–289CrossRefPubMed Yodogawa K, Ohara T, Takayama H, Seino Y, Katoh T, Mizuno K (2011) Detection of prior myocardial infarction patients prone to malignant ventricular arrhythmias using wavelet transform analysis. Int Heart J 52:286–289CrossRefPubMed
12.
Zurück zum Zitat Murata H, Ohara T, Kobayashi Y, Miyauchi Y, Katoh T, Mizuno K (2009) Detection of arrhythmogenic substrates in prior myocardial infarction patients with complete right bundle branch block QRS using wavelet-transformed ECG. J Nippon Med Sch 76:291–299CrossRefPubMed Murata H, Ohara T, Kobayashi Y, Miyauchi Y, Katoh T, Mizuno K (2009) Detection of arrhythmogenic substrates in prior myocardial infarction patients with complete right bundle branch block QRS using wavelet-transformed ECG. J Nippon Med Sch 76:291–299CrossRefPubMed
13.
Zurück zum Zitat Birnie DH, Sauer WH, Bogun F, Cooper JM, Culver DA, Duvernoy CS, Judson MA, Kron J, Mehta D, Cosedis Nielsen J, Patel AR, Ohe T, Raatikainen P, Soejima K (2014) HRS expert consensus statement on the diagnosis and management of arrhythmias associated with cardiac sarcoidosis. Heart Rhythm 11:1305–1323CrossRefPubMed Birnie DH, Sauer WH, Bogun F, Cooper JM, Culver DA, Duvernoy CS, Judson MA, Kron J, Mehta D, Cosedis Nielsen J, Patel AR, Ohe T, Raatikainen P, Soejima K (2014) HRS expert consensus statement on the diagnosis and management of arrhythmias associated with cardiac sarcoidosis. Heart Rhythm 11:1305–1323CrossRefPubMed
14.
Zurück zum Zitat Kasahara Y, Ashihara Y (1981) Colorimetry of angiotensin-I converting enzyme activity in serum. Clin Chem 27:1922–1925CrossRefPubMed Kasahara Y, Ashihara Y (1981) Colorimetry of angiotensin-I converting enzyme activity in serum. Clin Chem 27:1922–1925CrossRefPubMed
15.
Zurück zum Zitat Yodogawa K, Seino Y, Ohara T, Iwasaki YK, Hayashi M, Miyauchi Y, Azuma A, Shimizu W (2018) Prognostic significance of ventricular late potentials in patients with pulmonary sarcoidosis. Heart Rhythm 15:798–802CrossRefPubMed Yodogawa K, Seino Y, Ohara T, Iwasaki YK, Hayashi M, Miyauchi Y, Azuma A, Shimizu W (2018) Prognostic significance of ventricular late potentials in patients with pulmonary sarcoidosis. Heart Rhythm 15:798–802CrossRefPubMed
16.
Zurück zum Zitat Yi G, Hnatkova K, Mahon NG, Keeling PJ, Reardon M, Camm AJ, Malik M (2000) Predictive value of wavelet decomposition of the signal-averaged electrocardiogram in idiopathic dilated cardiomyopathy. Eur Heart J 21:1015–1022CrossRefPubMed Yi G, Hnatkova K, Mahon NG, Keeling PJ, Reardon M, Camm AJ, Malik M (2000) Predictive value of wavelet decomposition of the signal-averaged electrocardiogram in idiopathic dilated cardiomyopathy. Eur Heart J 21:1015–1022CrossRefPubMed
17.
Zurück zum Zitat Maehara K, Kokubun T, Awano N, Taira K, Ono M, Furukawa T, Shimizu Y, Maruyama Y (1999) Detection of abnormal high-frequency components in the QRS complex by the wavelet transform in patients with idiopathic dilated cardiomyopathy. Jpn Circ J 63:25–32CrossRefPubMed Maehara K, Kokubun T, Awano N, Taira K, Ono M, Furukawa T, Shimizu Y, Maruyama Y (1999) Detection of abnormal high-frequency components in the QRS complex by the wavelet transform in patients with idiopathic dilated cardiomyopathy. Jpn Circ J 63:25–32CrossRefPubMed
18.
Zurück zum Zitat Takayama H, Yodogawa K, Katoh T, Takano T (2006) Evaluation of arrhythmogenic substrate in patients with hypertrophic cardiomyopathy using wavelet transform analysis. Circ J 70:69–74CrossRefPubMed Takayama H, Yodogawa K, Katoh T, Takano T (2006) Evaluation of arrhythmogenic substrate in patients with hypertrophic cardiomyopathy using wavelet transform analysis. Circ J 70:69–74CrossRefPubMed
19.
Zurück zum Zitat Sengupta PP, Kulkarni H, Narula J (2018) Prediction of abnormal myocardial relaxation from signal processed surface ECG. J Am Coll Cardiol 71:1650–1660CrossRefPubMed Sengupta PP, Kulkarni H, Narula J (2018) Prediction of abnormal myocardial relaxation from signal processed surface ECG. J Am Coll Cardiol 71:1650–1660CrossRefPubMed
20.
Zurück zum Zitat Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, Deal BJ, Dickfeld T, Field ME, Fonarow GC, Gillis AM, Granger CB, Hammill SC, Hlatky MA, Joglar JA, Kay GN, Matlock DD, Myerburg RJ, Page RL (2018) 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: executive summary. Circulation 138:e210–e271PubMed Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, Deal BJ, Dickfeld T, Field ME, Fonarow GC, Gillis AM, Granger CB, Hammill SC, Hlatky MA, Joglar JA, Kay GN, Matlock DD, Myerburg RJ, Page RL (2018) 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: executive summary. Circulation 138:e210–e271PubMed
21.
Zurück zum Zitat Maisel AS, Krishnaswamy P, Nowak RM, McCord J, Hollander JE, Duc P, Omland T, Storrow AB, Abraham WT, Wu AH, Clopton P, Steg PG, Westheim A, Knudsen CW, Perez A, Kazanegra R, Herrmann HC, McCullough PA (2002) Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med 347:161–167CrossRefPubMed Maisel AS, Krishnaswamy P, Nowak RM, McCord J, Hollander JE, Duc P, Omland T, Storrow AB, Abraham WT, Wu AH, Clopton P, Steg PG, Westheim A, Knudsen CW, Perez A, Kazanegra R, Herrmann HC, McCullough PA (2002) Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med 347:161–167CrossRefPubMed
22.
Zurück zum Zitat Mueller C, Scholer A, Laule-Kilian K, Martina B, Schindler C, Buser P, Pfisterer M, Perruchoud AP (2004) Use of B-type natriuretic peptide in the evaluation and management of acute dyspnea. N Engl J Med 350:647–654CrossRefPubMed Mueller C, Scholer A, Laule-Kilian K, Martina B, Schindler C, Buser P, Pfisterer M, Perruchoud AP (2004) Use of B-type natriuretic peptide in the evaluation and management of acute dyspnea. N Engl J Med 350:647–654CrossRefPubMed
23.
Zurück zum Zitat Yasutake H, Seino Y, Kashiwagi M, Honma H, Matsuzaki T, Takano T (2005) Detection of cardiac sarcoidosis using cardiac markers and myocardial integrated backscatter. Int J Cardiol 102:259–268CrossRefPubMed Yasutake H, Seino Y, Kashiwagi M, Honma H, Matsuzaki T, Takano T (2005) Detection of cardiac sarcoidosis using cardiac markers and myocardial integrated backscatter. Int J Cardiol 102:259–268CrossRefPubMed
24.
Zurück zum Zitat Date T, Shinozaki T, Yamakawa M, Taniguchi I, Suda A, Hara H, Yamane T, Komukai K, Sugimoto K, Mochizuki S (2007) Elevated plasma brain natriuretic peptide level in cardiac sarcoidosis patients with preserved ejection fraction. Cardiology 107:277–280CrossRefPubMed Date T, Shinozaki T, Yamakawa M, Taniguchi I, Suda A, Hara H, Yamane T, Komukai K, Sugimoto K, Mochizuki S (2007) Elevated plasma brain natriuretic peptide level in cardiac sarcoidosis patients with preserved ejection fraction. Cardiology 107:277–280CrossRefPubMed
25.
26.
Zurück zum Zitat Kiko T, Yoshihisa A, Kanno Y, Yokokawa T, Abe S, Miyata-Tatsumi M, Misaka T, Oikawa M, Kobayashi A, Ishida T, Takeishi Y (2018) A multiple biomarker approach in patients with cardiac sarcoidosis. Int Heart J 59:996–1001CrossRefPubMed Kiko T, Yoshihisa A, Kanno Y, Yokokawa T, Abe S, Miyata-Tatsumi M, Misaka T, Oikawa M, Kobayashi A, Ishida T, Takeishi Y (2018) A multiple biomarker approach in patients with cardiac sarcoidosis. Int Heart J 59:996–1001CrossRefPubMed
Metadaten
Titel
Detection of arrhythmogenic substrate within QRS complex in patients with cardiac sarcoidosis using wavelet-transformed ECG
verfasst von
Kenji Yodogawa
Toshihiko Ohara
Hiroshige Murata
Yu-ki Iwasaki
Yoshihiko Seino
Wataru Shimizu
Publikationsdatum
17.03.2020
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 8/2020
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-020-01584-2

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