Identifying Obstructive Hypertrophic Cardiomyopathy from Nonobstructive Hypertrophic Cardiomyopathy: Development and Validation of a Model Based on Electrocardiogram Features. 2023

Lanyan Guo, and Zhiling Ma, and Weiping Yang, and Fuyang Zhang, and Hong Shao, and Liwen Liu, and Chao Gao, and Ling Tao
Department of Cardiology, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, China.

The clinical presentation and prognosis of hypertrophic cardiomyopathy (HCM) are heterogeneous between nonobstructive HCM (HNCM) and obstructive HCM (HOCM). Electrocardiography (ECG) has been used as a screening tool for HCM. However, it is still unclear whether the features presented on ECG could be used for the initial classification of HOCM and HNCM. We aimed to develop a pragmatic model based on common 12-lead ECG features for the initial identification of HOCM/HNCM. Between April 1st and September 30th, 2020, 172 consecutive HCM patients from the International Cooperation Center for Hypertrophic Cardiomyopathy of Xijing Hospital were prospectively included in the training cohort. Between January 4th and February 30th, 2021, an additional 62 HCM patients were prospectively included in the temporal internal validation cohort. External validation was performed using retrospectively collected ECG data with definite classification (390 HOCM and 499 HNCM ECG samples) from January 1st, 2010 to March 31st, 2020. Multivariable backward logistic regression (LR) was used to develop the prediction model. The discrimination performance, calibration and clinical utility of the model were evaluated. Of all 30 acquired ECG parameters, 10 variables were significantly different between HOCM and HNCM (all P < 0.05). The P wave interval and SV1 were selected to construct the model, which had a clearly useful C-statistic of 0.805 (0.697, 0.914) in the temporal validation cohort and 0.776 (0.746, 0.806) in the external validation cohort for differentiating HOCM from HNCM. The calibration plot, decision curve analysis, and clinical impact curve indicated that the model had good fitness and clinical utility. The pragmatic model constructed by the P wave interval and SV1 had a clearly useful ability to discriminate HOCM from HNCM. The model might potentially serve as an initial classification of HCM before referring patients to dedicated centers and specialists. What are the novel findings of this work? Evident differences exist in the ECG presentations between HOCM and HNCM.To the best of our knowledge, this study is the first piece of evidence to quantify the difference in the ECG presentations between HOCM and HNCM.Based on routine 12-lead ECG data, a probabilistic model was generated that might assist in the initial classification of HCM patients.

UI MeSH Term Description Entries
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D002312 Cardiomyopathy, Hypertrophic A form of CARDIAC MUSCLE disease, characterized by left and/or right ventricular hypertrophy (HYPERTROPHY, LEFT VENTRICULAR; HYPERTROPHY, RIGHT VENTRICULAR), frequent asymmetrical involvement of the HEART SEPTUM, and normal or reduced left ventricular volume. Risk factors include HYPERTENSION; AORTIC STENOSIS; and gene MUTATION; (FAMILIAL HYPERTROPHIC CARDIOMYOPATHY). Cardiomyopathy, Hypertrophic Obstructive,Cardiomyopathies, Hypertrophic,Cardiomyopathies, Hypertrophic Obstructive,Hypertrophic Cardiomyopathies,Hypertrophic Cardiomyopathy,Hypertrophic Obstructive Cardiomyopathies,Hypertrophic Obstructive Cardiomyopathy,Obstructive Cardiomyopathies, Hypertrophic,Obstructive Cardiomyopathy, Hypertrophic
D004562 Electrocardiography Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY. 12-Lead ECG,12-Lead EKG,12-Lead Electrocardiography,Cardiography,ECG,EKG,Electrocardiogram,Electrocardiograph,12 Lead ECG,12 Lead EKG,12 Lead Electrocardiography,12-Lead ECGs,12-Lead EKGs,12-Lead Electrocardiographies,Cardiographies,ECG, 12-Lead,EKG, 12-Lead,Electrocardiograms,Electrocardiographies, 12-Lead,Electrocardiographs,Electrocardiography, 12-Lead
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

Related Publications

Lanyan Guo, and Zhiling Ma, and Weiping Yang, and Fuyang Zhang, and Hong Shao, and Liwen Liu, and Chao Gao, and Ling Tao
August 1998, The American journal of cardiology,
Lanyan Guo, and Zhiling Ma, and Weiping Yang, and Fuyang Zhang, and Hong Shao, and Liwen Liu, and Chao Gao, and Ling Tao
October 2023, Acta cardiologica,
Lanyan Guo, and Zhiling Ma, and Weiping Yang, and Fuyang Zhang, and Hong Shao, and Liwen Liu, and Chao Gao, and Ling Tao
January 2005, Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics,
Lanyan Guo, and Zhiling Ma, and Weiping Yang, and Fuyang Zhang, and Hong Shao, and Liwen Liu, and Chao Gao, and Ling Tao
September 1978, Circulation,
Lanyan Guo, and Zhiling Ma, and Weiping Yang, and Fuyang Zhang, and Hong Shao, and Liwen Liu, and Chao Gao, and Ling Tao
December 1980, The Journal of clinical investigation,
Lanyan Guo, and Zhiling Ma, and Weiping Yang, and Fuyang Zhang, and Hong Shao, and Liwen Liu, and Chao Gao, and Ling Tao
January 2015, International heart journal,
Lanyan Guo, and Zhiling Ma, and Weiping Yang, and Fuyang Zhang, and Hong Shao, and Liwen Liu, and Chao Gao, and Ling Tao
July 1974, Journal of clinical pathology,
Lanyan Guo, and Zhiling Ma, and Weiping Yang, and Fuyang Zhang, and Hong Shao, and Liwen Liu, and Chao Gao, and Ling Tao
February 2018, Journal of the American Heart Association,
Lanyan Guo, and Zhiling Ma, and Weiping Yang, and Fuyang Zhang, and Hong Shao, and Liwen Liu, and Chao Gao, and Ling Tao
September 2015, The American journal of cardiology,
Lanyan Guo, and Zhiling Ma, and Weiping Yang, and Fuyang Zhang, and Hong Shao, and Liwen Liu, and Chao Gao, and Ling Tao
January 1991, The American journal of cardiology,
Copied contents to your clipboard!