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[PMID]:28990923
[Au] Autor:Yé Y; Eisele TP; Eckert E; Korenromp E; Shah JA; Hershey CL; Ivanovich E; Newby H; Carvajal-Velez L; Lynch M; Komatsu R; Cibulskis RE; Moore Z; Bhattarai A
[Ad] Endereço:MEASURE Evaluation, ICF, Rockville, Maryland.
[Ti] Título:Framework for Evaluating the Health Impact of the Scale-Up of Malaria Control Interventions on All-Cause Child Mortality in Sub-Saharan Africa.
[So] Source:Am J Trop Med Hyg;97(3_Suppl):9-19, 2017 Sep.
[Is] ISSN:1476-1645
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Concerted efforts from national and international partners have scaled up malaria control interventions, including insecticide-treated nets, indoor residual spraying, diagnostics, prompt and effective treatment of malaria cases, and intermittent preventive treatment during pregnancy in sub-Saharan Africa (SSA). This scale-up warrants an assessment of its health impact to guide future efforts and investments; however, measuring malaria-specific mortality and the overall impact of malaria control interventions remains challenging. In 2007, Roll Back Malaria's Monitoring and Evaluation Reference Group proposed a theoretical framework for evaluating the impact of full-coverage malaria control interventions on morbidity and mortality in high-burden SSA countries. Recently, several evaluations have contributed new ideas and lessons to strengthen this plausibility design. This paper harnesses that new evaluation experience to expand the framework, with additional features, such as stratification, to examine subgroups most likely to experience improvement if control programs are working; the use of a national platform framework; and analysis of complete birth histories from national household surveys. The refined framework has shown that, despite persisting data challenges, combining multiple sources of data, considering potential contributions from both fundamental and proximate contextual factors, and conducting subnational analyses allows identification of the plausible contributions of malaria control interventions on malaria morbidity and mortality.
[Mh] Termos MeSH primário: Mortalidade da Criança/tendências
Malária/complicações
Malária/prevenção & controle
Modelos Teóricos
[Mh] Termos MeSH secundário: África ao Sul do Saara/epidemiologia
Animais
Antimaláricos/administração & dosagem
Antimaláricos/economia
Antimaláricos/uso terapêutico
Criança
Pré-Escolar
Seres Humanos
Insetos Vetores
Malária/economia
Malária/epidemiologia
Controle de Mosquitos
Praguicidas
Fatores Socioeconômicos
Vetorcardiografia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antimalarials); 0 (Pesticides)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171010
[St] Status:MEDLINE
[do] DOI:10.4269/ajtmh.15-0363


  2 / 4019 MEDLINE  
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[PMID]:28017302
[Au] Autor:Deng M; Tang M; Wang C; Shan L; Zhang L; Zhang J; Wu W; Xia L
[Ad] Endereço:College of Automation, South China University of Technology, Guangzhou, China; Key Laboratory of Biomedical Engineering in Guangdong, Guangzhou, China.
[Ti] Título:Cardiodynamicsgram as a New Diagnostic Tool in Coronary Artery Disease Patients With Nondiagnostic Electrocardiograms.
[So] Source:Am J Cardiol;119(5):698-704, 2017 Mar 01.
[Is] ISSN:1879-1913
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cardiodynamicsgram (CDG) has emerged recently as a noninvasive spatiotemporal electrocardiographic method for subtle cardiac dynamics information analysis within electrocardiogram (ECG). This study sought to evaluate the clinical utility of CDG for early coronary artery disease (CAD) detection in suspected patients with CAD presenting with nondiagnostic ECGs. A total of 421 suspected patients with CAD presenting with nondiagnostic ECG were enrolled. Standard 12-lead ECG and CDG were performed simultaneously, 1 day before invasive coronary angiography. Diagnostic accuracy of CDG for early CAD detection was assessed with reference to coronary angiography as the gold standard. Coronary angiography showed ≥1 coronary arteries stenosis of >50% in 347 patients. Of these 347 patients with CAD, 294 patients were positive in CDG. Of 74 non-CAD controls, 63 patients were negative in CDG. Diagnostic accuracy of CDG at presentation for CAD was 84.6%, sensitivity 84.7%, and specificity 83.7%. In patients presenting with nondiagnostic ECGs, an abnormal status can be detected early through noninvasive CDG. CDG is highly sensitive for the early diagnosis of CAD. Underlying causes of false-negative CDG findings included number of diseased coronary arteries and collateral circulation. Subtle myocardial damage that was not detectable on coronary angiography might be the major cause of false-positive findings.
[Mh] Termos MeSH primário: Doença da Artéria Coronariana/diagnóstico
Estenose Coronária/diagnóstico
Vetorcardiografia/métodos
[Mh] Termos MeSH secundário: Idoso
Circulação Colateral
Angiografia Coronária
Doença da Artéria Coronariana/diagnóstico por imagem
Estenose Coronária/diagnóstico por imagem
Eletrocardiografia/métodos
Feminino
Seres Humanos
Masculino
Meia-Idade
Sensibilidade e Especificidade
Análise Espaço-Temporal
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170524
[Lr] Data última revisão:
170524
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161227
[St] Status:MEDLINE


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[PMID]:27246458
[Au] Autor:Cortez D; Sharma N; Cavanaugh J; Tuozo F; Derk G; Lundberg E; Weiner K; Kiciman N; Alejos J; Landeck B; Aboulhosn J; Miyamoto S; McCanta AC; Batra AS
[Ad] Endereço:1Children's Hospital Colorado/University of Colorado,Aurora,Colorado,United States of America.
[Ti] Título:Lower spatial QRS-T angle rules out sustained ventricular arrhythmias in children with hypertrophic cardiomyopathy.
[So] Source:Cardiol Young;27(2):354-358, 2017 Mar.
[Is] ISSN:1467-1107
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Introduction The spatial peaks QRS-T angle accurately distinguishes children with hypertrophic cardiomyopathy from their healthy counterparts. The spatial peaks QRS-T angle is also useful in risk stratification for ventricular arrhythmias. We hypothesised that the spatial peaks QRS-T angle would be useful for the prediction of ventricular arrhythmias in hypertrophic cardiomyopathy patients under 23 years of age. METHODS: Corrected QT interval and spatial peaks QRS-T angles were retrospectively assessed in 133 paediatric hypertrophic cardiomyopathy patients (12.4±6.6 years) with versus without ventricular arrhythmias of 30 seconds or longer. Significance, positive/negative predictive values, and odds ratios were calculated based on receiver operating characteristic curve cut-off values. RESULTS: In total, 10 patients with ventricular arrhythmias were identified. Although the corrected QT interval did not differentiate those with versus without ventricular arrhythmias, the spatial peaks QRS-T angle did (151.4±19.0 versus 116.8±42.6 degrees, respectively, p<0.001). At an optimal cut-off value (124.1 degrees), the positive and negative predictive values of the spatial peaks QRS-T angle were 15.4 and 100.0%, respectively, with an odds ratio of 25.9 (95% CI 1.5-452.2). CONCLUSION: In children with hypertrophic cardiomyopathy, the spatial peaks QRS-T angle is associated with ventricular arrhythmia burden with high negative predictive value and odds ratio.
[Mh] Termos MeSH primário: Cardiomiopatia Hipertrófica/complicações
Taquicardia Ventricular/diagnóstico
Vetorcardiografia
[Mh] Termos MeSH secundário: Adolescente
Cardiomiopatia Hipertrófica/diagnóstico
Criança
Diagnóstico Diferencial
Feminino
Seguimentos
Seres Humanos
Masculino
Razão de Chances
Valor Preditivo dos Testes
Curva ROC
Estudos Retrospectivos
Taquicardia Ventricular/etiologia
Taquicardia Ventricular/fisiopatologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170615
[Lr] Data última revisão:
170615
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160602
[St] Status:MEDLINE
[do] DOI:10.1017/S1047951116000640


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[PMID]:28011837
[Au] Autor:Villongco CT; Krummen DE; Omens JH; McCulloch AD
[Ad] Endereço:Department of Bioengineering, University of California, 9500 Gilman Drive, La Jolla, San Diego, CA 92093-0412, USA.
[Ti] Título:Non-invasive, model-based measures of ventricular electrical dyssynchrony for predicting CRT outcomes.
[So] Source:Europace;18(suppl 4):iv104-iv112, 2016 Dec.
[Is] ISSN:1532-2092
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Left ventricular activation delay due to left bundle branch block (LBBB) is an important determinant of the severity of dyssynchronous heart failure (DHF). We investigated whether patient-specific computational models constructed from non-invasive measurements can provide measures of baseline dyssynchrony and its reduction after CRT that may explain the degree of long-term reverse ventricular remodelling. METHODS AND RESULTS: LV end-systolic volume reduction (ΔESV ) measured by 2D trans-thoracic echocardiography in eight patients following 6 months of CRT was significantly (P < 0.05) greater in responders (26 ± 20%, n = 4) than non-responders (11 ± 16%, n = 4). LV reverse remodelling did not correlate with baseline QRS duration or its change after biventricular pacing, but did correlate with baseline LV endocardial activation measured by electroanatomic mapping (R = 0.71, P < 0.01). Patient-specific models of LBBB ventricular activation with parameters obtained by matching model-computed vectorcardiograms (VCG) to those derived from standard patient ECGs yielded LV endocardial activation times that correlated well with those measured from endocardial maps (R = 0.90). Model-computed 3D LV activation times correlated strongly with the reduction in LVESV (R = 0.93, P < 0.001). Computed decreases due to simulated CRT in the time delay between LV septal and lateral activation correlated strongly with ΔESV (R = 0.92, P < 0.001). Models also suggested that optimizing VV delays may improve resynchronization by this measure of activation delay. CONCLUSIONS: Patient-specific computational models constructed from non-invasive measurements can compute estimates of LV dyssynchrony and their changes after CRT that may be as good as or better than electroanatomic mapping for predicting long-term reverse remodelling.
[Mh] Termos MeSH primário: Bloqueio de Ramo/terapia
Terapia de Ressincronização Cardíaca/métodos
Insuficiência Cardíaca/terapia
Modelos Cardiovasculares
Modelagem Computacional Específica para o Paciente
Disfunção Ventricular Esquerda/terapia
Função Ventricular Esquerda
[Mh] Termos MeSH secundário: Potenciais de Ação
Idoso
Bloqueio de Ramo/diagnóstico
Bloqueio de Ramo/fisiopatologia
Eletrocardiografia
Técnicas Eletrofisiológicas Cardíacas
Insuficiência Cardíaca/diagnóstico
Insuficiência Cardíaca/fisiopatologia
Frequência Cardíaca
Seres Humanos
Masculino
Meia-Idade
Valor Preditivo dos Testes
Recuperação de Função Fisiológica
Processamento de Sinais Assistido por Computador
Volume Sistólico
Fatores de Tempo
Resultado do Tratamento
Vetorcardiografia
Disfunção Ventricular Esquerda/diagnóstico
Disfunção Ventricular Esquerda/fisiopatologia
Remodelação Ventricular
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161225
[St] Status:MEDLINE
[do] DOI:10.1093/europace/euw356


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[PMID]:28011830
[Au] Autor:Engels EB; Poels TT; Houthuizen P; de Jaegere PP; Maessen JG; Vernooy K; Prinzen FW
[Ad] Endereço:Department of Physiology, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.
[Ti] Título:Electrical remodelling in patients with iatrogenic left bundle branch block.
[So] Source:Europace;18(suppl 4):iv44-iv52, 2016 Dec.
[Is] ISSN:1532-2092
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Left bundle branch block (LBBB) is induced in approximately one-third of all transcatheter aortic valve implantation (TAVI) procedures. We investigated electrophysiological remodelling in patients with TAVI-induced LBBB. METHODS AND RESULTS: This retrospective study comprises 107 patients with initially narrow QRS complex of whom 40 did not and 67 did develop persistent LBBB after TAVI. 12-lead electrocardiograms (ECGs) taken before TAVI, within 24 hours ('acute'), and 1-12 months after TAVI ('chronic') were used to reconstruct vectorcardiograms. From these vectorcardiograms, QRS and T-wave area were calculated as comprehensive indices of depolarization and repolarization abnormalities, respectively. TAVI-induced LBBB resulted in significant acute depolarization and repolarization changes while further repolarization changes were observed with longer lasting LBBB. The amount of long-term repolarization changes (remodelling) was highly variable between patients. The change in T-wave area between acute and chronic LBBB ranged from +57% to - 77%. After dividing the LBBB cohort into tertiles based on the change in T-wave area, only baseline QRS area was larger in the tertile with no significant change in T-wave area. During longer lasting LBBB, the spatial vector gradient (SVG) changed orientation towards the direction of the QRS-vector, indicating that later-activated regions developed shorter action potential duration. CONCLUSION: This study in patients with TAVI-induced LBBB shows that repolarization changes develop within months after onset of LBBB, and that these changes are highly variable between individual patients.
[Mh] Termos MeSH primário: Potenciais de Ação
Fascículo Atrioventricular/fisiopatologia
Bloqueio de Ramo/fisiopatologia
Doença Iatrogênica
Modelos Cardiovasculares
Modelagem Computacional Específica para o Paciente
Substituição da Valva Aórtica Transcateter/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Bloqueio de Ramo/diagnóstico
Bloqueio de Ramo/etiologia
Eletrocardiografia
Feminino
Frequência Cardíaca
Seres Humanos
Masculino
Países Baixos
Valor Preditivo dos Testes
Estudos Retrospectivos
Processamento de Sinais Assistido por Computador
Fatores de Tempo
Vetorcardiografia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161225
[St] Status:MEDLINE
[do] DOI:10.1093/europace/euw350


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[PMID]:27865582
[Au] Autor:Verdurmen KM; Hulsenboom AD; van Laar JO; Wijn PF; Vullings R; Oei SG
[Ad] Endereço:Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands. Electronic address: kimverdurmen@live.nl.
[Ti] Título:Orientation of the electrical heart axis in mid-term pregnancy.
[So] Source:Eur J Obstet Gynecol Reprod Biol;207:243-246, 2016 Dec.
[Is] ISSN:1872-7654
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Mh] Termos MeSH primário: Cardiotocografia/métodos
Coração/embriologia
Vetorcardiografia/métodos
[Mh] Termos MeSH secundário: Adulto
Ecocardiografia
Eletrodos
Feminino
Coração/diagnóstico por imagem
Coração/fisiologia
Coração/fisiopatologia
Cardiopatias/diagnóstico
Cardiopatias/diagnóstico por imagem
Cardiopatias/embriologia
Cardiopatias/fisiopatologia
Hospitais de Ensino
Seres Humanos
Países Baixos
Gravidez
Segundo Trimestre da Gravidez
Diagnóstico Pré-Natal/métodos
Estudos Prospectivos
Processamento de Sinais Assistido por Computador
Ultrassonografia Pré-Natal
[Pt] Tipo de publicação:LETTER
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170414
[Lr] Data última revisão:
170414
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161121
[St] Status:MEDLINE


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[PMID]:27580222
[Au] Autor:Arámbula-Garza E; Castillo-Martínez L; González-Islas D; Orea-Tejeda A; Santellano-Juárez B; Keirns-Davies C; Peláez-Hernández V; Sánchez-Santillán R; Pineda-Juárez J; Cintora-Martínez C; Pablo-Santiago R
[Ad] Endereço:Heart Failure and Respiratory Distress Clinic, Cardiology Department, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico; Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" Mexico City, Mexico.
[Ti] Título:Association of cardiac cachexia and atrial fibrillation in heart failure patients.
[So] Source:Int J Cardiol;223:863-866, 2016 Nov 15.
[Is] ISSN:1874-1754
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cachexia is a common complication in patients with advanced heart failure (HF) associated with inflammatory response activation. Atrial fibrillation (AF) is the most frequent arrhythmia (26%), probably both exacerbate the cardiac cachexia (CC). OBJECTIVES: Evaluate the association of cardiac cachexia and atrial fibrillation in heart failure patients. MATERIAL AND METHODS: In a case control study, CC was diagnosed by electrical bioimpedance with vectorial analysis (BIVA). Subjects with congenital heart disease, cancer, HIV, drug use and other causes than HF were excluded. RESULTS: Of the 359 subjects analyzed (men: 52.9%) median age 65years (55-74). Those with CC were older [72 (61-67)] vs. without [62 (52-70) years old, p<0.01]. During follow-up 47.8% of subjects developed CC and 17.27% AF, this was significantly more frequent in cachectic patients CC (23% vs 12.11%, OR: 2.17, 95% CI: 1.19-4.01, p=0.006). Subjects, with AF had lower left ventricular ejection fraction (25.49±12.96 vs. 32.01±15.02, p=0.08), lower posterior wall thickness (10.03±2.12 vs. 11.00±2.47, p=0.007), larger diameter of the left atrium (49.87±9.84 vs. 42.66±7.56, p<0.001), and a higher prevalence of CC (85.42% vs. 69.77%, p=0.028). The 50.58% of was in NYHA class I. In NYHA III, 22.95% were in AF vs. 12.10% with not AF (p=0.027). CONCLUSION: The frequent coexistence of CC and AF as HF complications indicate greater severity of HF, regardless of its type of HF.
[Mh] Termos MeSH primário: Fibrilação Atrial
Caquexia
Impedância Elétrica
Insuficiência Cardíaca
[Mh] Termos MeSH secundário: Idoso
Fibrilação Atrial/diagnóstico
Fibrilação Atrial/etiologia
Fibrilação Atrial/fisiopatologia
Caquexia/diagnóstico
Caquexia/etiologia
Caquexia/fisiopatologia
Estudos de Casos e Controles
Feminino
Insuficiência Cardíaca/complicações
Insuficiência Cardíaca/diagnóstico
Insuficiência Cardíaca/epidemiologia
Insuficiência Cardíaca/fisiopatologia
Seres Humanos
Masculino
México/epidemiologia
Meia-Idade
Índice de Gravidade de Doença
Volume Sistólico
Vetorcardiografia/métodos
Função Ventricular Esquerda
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171009
[Lr] Data última revisão:
171009
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160901
[St] Status:MEDLINE


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[PMID]:27203188
[Au] Autor:Lingman M; Hartford M; Karlsson T; Herlitz J; Rubulis A; Caidahl K; Bergfeldt L
[Ad] Endereço:Institute of Medicine, Dept of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Dept of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Dept of Medicine, Halland Hospital, Sweden. Electronic address: markus.lingman@regionhalland.se.
[Ti] Título:Value of the QRS-T area angle in improving the prediction of sudden cardiac death after acute coronary syndromes.
[So] Source:Int J Cardiol;218:1-11, 2016 Sep 01.
[Is] ISSN:1874-1754
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Prediction of sudden cardiac death (SCD) after acute coronary syndromes (ACS) remains a challenge. Although electrophysiology measures obtained by 3-D vectorcardiography (VCG) shortly after ACS may be useful predictors of SCD, they have not been adopted into clinical practice. The main objective of our study was to assess whether the VCG-derived QRS-T area angle (between area vectors) and the QRS-T angle (between maximum vectors) have additional value beyond standard risk factors in predicting SCD after ACS. METHODS AND RESULTS: We studied 643 consecutive ACS patients for whom data on VCG and echocardiography during the index hospitalization were available. Seventy-seven patients (12%) died, 37 (6%) from SCD and 21 (3%) from other cardiac causes during the 30-month follow-up. After adjusting for 9 standard risk factors (age, sex, diabetes, previous stroke, left ventricular ejection fraction; and estimated glomerular filtration rate, heart rate, systolic blood pressure<100mmHg, and Killip class>1 on admission), QRS-T area angle and QRS-T angle were shown to have independent predictive value for both SCD and all cardiac deaths. Reclassification analysis showed that both measures had additional predictive value beyond the 9 standard risk factors. For SCD, net reclassification improvements for QRS-T area angle and QRS-T angle were 46% and 45% and relative integrated discriminative improvements were 16% and 13% (vs the average~11% of the 9 standard risk factors). CONCLUSIONS: The VCG-derived QRS-T area angle and QRS-T angle improved prediction of SCD after ACS beyond standard risk factors. Further evaluation of their clinical utility and cost-effectiveness is therefore warranted.
[Mh] Termos MeSH primário: Síndrome Coronariana Aguda/mortalidade
Síndrome Coronariana Aguda/fisiopatologia
Morte Súbita Cardíaca/epidemiologia
Vetorcardiografia/normas
[Mh] Termos MeSH secundário: Síndrome Coronariana Aguda/diagnóstico
Idoso
Morte Súbita Cardíaca/prevenção & controle
Eletrocardiografia/métodos
Eletrocardiografia/normas
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Valor Preditivo dos Testes
Fatores de Risco
Vetorcardiografia/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170910
[Lr] Data última revisão:
170910
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160521
[St] Status:MEDLINE


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[PMID]:27124801
[Au] Autor:Reichlin T; Abächerli R; Twerenbold R; Kühne M; Schaer B; Müller C; Sticherling C; Osswald S
[Ad] Endereço:Division of Cardiology, University Hospital Basel, Switzerland; Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
[Ti] Título:Advanced ECG in 2016: is there more than just a tracing?
[So] Source:Swiss Med Wkly;146:w14303, 2016.
[Is] ISSN:1424-3997
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:The 12-lead electrocardiogram (ECG) is the most frequently used technology in clinical cardiology. It is critical for evidence-based management of patients with most cardiovascular conditions, including patients with acute myocardial infarction, suspected chronic cardiac ischaemia, cardiac arrhythmias, heart failure and implantable cardiac devices. In contrast to many other techniques in cardiology, the ECG is simple, small, mobile, universally available and cheap, and therefore particularly attractive. Standard ECG interpretation mainly relies on direct visual assessment. The progress in biomedical computing and signal processing, and the available computational power offer fascinating new options for ECG analysis relevant to all fields of cardiology. Several digital ECG markers and advanced ECG technologies have shown promise in preliminary studies. This article reviews promising novel surface ECG technologies in three different fields. (1) For the detection of myocardial ischaemia and infarction, QRS morphology feature analysis, the analysis of high frequency QRS components (HF-QRS) and methods using vectorcardiography as well as ECG imaging are discussed. (2) For the identification and management of patients with cardiac arrhythmias, methods of advanced P-wave analysis are discussed and the concept of ECG imaging for noninvasive localisation of cardiac arrhythmias is presented. (3) For risk stratification of sudden cardiac death and the selection of patients for medical device therapy, several novel markers including an automated QRS-score for scar quantification, the QRS-T angle or the T-wave peak-to-end-interval are discussed. Despite the existing preliminary data, none of the advanced ECG markers and technologies has yet accomplished the transition into clinical practice. Further refinement of these technologies and broader validation in large unselected patient cohorts are the critical next step needed to facilitate translation of advanced ECG technologies into clinical cardiology.
[Mh] Termos MeSH primário: Arritmias Cardíacas/diagnóstico
Eletrocardiografia/métodos
Insuficiência Cardíaca/diagnóstico
Isquemia Miocárdica/diagnóstico
[Mh] Termos MeSH secundário: Eletrocardiografia/tendências
Seres Humanos
Processamento de Sinais Assistido por Computador
Vetorcardiografia/métodos
Vetorcardiografia/tendências
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1610
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160429
[St] Status:MEDLINE


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[PMID]:27063981
[Au] Autor:Correa R; Arini PD; Correa LS; Valentinuzzi M; Laciar E
[Ad] Endereço:Raúl Correa, Gabinete de Tecnología Médica - Facultad de Ingeniería, Universidad Nacional de San Juan, Av. Libertador General San Martín 1109 (O), J5400ARL - San Juan, Argentina, E-mail: rcorrea@gateme.unsj.edu.ar.
[Ti] Título:Identification of Patients with Myocardial Infarction. Vectorcardiographic and Electrocardiographic Analysis.
[So] Source:Methods Inf Med;55(3):242-9, 2016 May 17.
[Is] ISSN:2511-705X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The largest morbidity and mortality group worldwide continues to be that suffering Myocardial Infarction (MI). The use of vectorcardiography (VCG) and electrocardiography (ECG) has improved the diagnosis and characterization of this cardiac condition. OBJECTIVES: Herein, we applied a novel ECG-VCG combination technique to identifying 95 patients with MI and to differentiating them from 52 healthy reference subjects. Subsequently, and with a similar method, the location of the infarcted area permitted patient classification. METHODS: We analyzed five depolarization and four repolarization indexes, say: a) volume; b) planar area; c) QRS loop perimeter; d) QRS vector difference; e - g) Area under the QRS complex, ST segment and T-wave in the (X, Y, Z) leads; h) ST-T Vector Magnitude Difference; i) T-wave Vector Magnitude Difference; and j) the spatial angle between the QRS complex and the T-wave. For classification, patients were divided into two groups according to the infarcted area, that is, anterior or inferior sectors (MI-ant and MI-inf, respectively). RESULTS: Our results indicate that several ECG and VCG parameters show significant differences (p-value<0.05) between Healthy and MI subjects, and between MI-ant and MI-inf. Moreover, combining five parameters, it was possible to classify the MI and healthy subjects with a sensitivity = 95.8%, a specificity = 94.2%, and an accuracy = 95.2%, after applying a linear discriminant classifier method. Similarly, combining eight indexes, we could separate out the MI patients in MI-ant vs MI-inf with a sensitivity = 89.8%, 84.8%, respectively, and an accuracy = 89.8%. CONCLUSIONS: The new multivariable MI patient identification and localization technique, based on ECG and VCG combination indexes, offered excellent performance to differentiating populations with MI from healthy subjects. Furthermore, this technique might be applicable to estimating the infarcted area localization. In addition, the proposed method would be an alternative diagnostic technique in the emergency room.
[Mh] Termos MeSH primário: Infarto do Miocárdio/diagnóstico
Vetorcardiografia
[Mh] Termos MeSH secundário: Algoritmos
Estudos de Casos e Controles
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170424
[Lr] Data última revisão:
170424
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160412
[St] Status:MEDLINE
[do] DOI:10.3414/ME15-01-0101



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