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Diagnostic utility of electrocardiogram for screening of cardiac injury on cardiac magnetic resonance in post-hospitalised COVID-19 patients: a prospective multicenter study.
Samat, Azlan Helmy Abd; Cassar, Mark P; Akhtar, Abid M; McCracken, Celeste; Ashkir, Zakariye M; Mills, Rebecca; Moss, Alastair J; Finnigan, Lucy E M; Lewandowski, Adam J; Mahmod, Masliza; Ogbole, Godwin I; Tunnicliffe, Elizabeth M; Lukaschuk, Elena; Piechnik, Stefan K; Ferreira, Vanessa M; Nikolaidou, Chrysovalantou; Rahman, Najib M; Ho, Ling-Pei; Harris, Victoria C; Singapuri, Amisha; Manisty, Charlotte; O'Regan, Declan P; Weir-McCall, Jonathan R; Steeds, Richard P; Llm, Krisnah Poinasamy; Cuthbertson, Dan J; Kemp, Graham J; Horsley, Alexander; Miller, Christopher A; O'Brien, Caitlin; Chiribiri, Amedeo; Francis, Susan T; Chalmers, James D; Plein, Sven; Poener, Ana-Maria; Wild, James M; Treibel, Thomas A; Marks, Michael; Toshner, Mark; Wain, Louise V; Evans, Rachael A; Brightling, Christopher E; Neubauer, Stefan; McCann, Gerry P; Raman, Betty.
Afiliación
  • Samat AHA; Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK; Department of Emergency Medicine, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
  • Cassar MP; Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK.
  • Akhtar AM; Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK.
  • McCracken C; University of Oxford, Oxford, UK.
  • Ashkir ZM; Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK.
  • Mills R; Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK.
  • Moss AJ; University Hospitals of Leicester NHS Trust & University of Leicester, Leicester, UK.
  • Finnigan LEM; University of Oxford, Oxford, UK.
  • Lewandowski AJ; Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK.
  • Mahmod M; Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK.
  • Ogbole GI; University of Oxford, Oxford, UK; Department of Radiology, University of Ibadan, Nigeria.
  • Tunnicliffe EM; Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK.
  • Lukaschuk E; University of Oxford, Oxford, UK.
  • Piechnik SK; University of Oxford, Oxford, UK.
  • Ferreira VM; Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK.
  • Nikolaidou C; Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK.
  • Rahman NM; Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK; Oxford NIHR Biomedical Research Center, Oxford, UK; Oxford Chinese Academy of Medicine Institute, Oxford, UK.
  • Ho LP; Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK.
  • Harris VC; University Hospitals of Leicester NHS Trust & University of Leicester, Leicester, UK.
  • Singapuri A; University Hospitals of Leicester NHS Trust & University of Leicester, Leicester, UK.
  • Manisty C; Barts Health NHS Trust, London, UK.
  • O'Regan DP; MRC London Institute of Medical Sciences, Imperial College London, UK.
  • Weir-McCall JR; Royal Papworth Hospital, Cambridge, UK; Cambridge NIHR BRC and the NIHR Cambridge Clinical Research Facility, Cambridge, UK.
  • Steeds RP; University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Llm KP; Asthma UK and British Lung Foundation Partnership, UK.
  • Cuthbertson DJ; University of Liverpool and Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
  • Kemp GJ; University of Liverpool and Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
  • Horsley A; Manchester University NHS Foundation Trust & University of Manchester, Manchester, UK.
  • Miller CA; Manchester University NHS Foundation Trust & University of Manchester, Manchester, UK.
  • O'Brien C; King's College London, Guy's & St Thomas' NHS Foundation Trust, London, UK.
  • Chiribiri A; King's College London, Guy's & St Thomas' NHS Foundation Trust, London, UK.
  • Francis ST; University of Nottingham, Nottingham, UK.
  • Chalmers JD; NHS Tayside & University of Dundee, Dundee, UK.
  • Plein S; University of Leeds & Leeds Teaching Hospitals, Leeds, UK.
  • Poener AM; University of Leeds & Leeds Teaching Hospitals, Leeds, UK.
  • Wild JM; Sheffield Teaching Hospitals, University of Sheffield, Leicester, UK.
  • Treibel TA; University College London NHS Foundation Trust, London, UK.
  • Marks M; University College London NHS Foundation Trust, London, UK; London School of Hygiene & Tropical Medicine, London, UK.
  • Toshner M; Heart and Lung Research Institute, Dept of Medicine, Cambridge, UK; Cambridge NIHR BRC and the NIHR Cambridge Clinical Research Facility, Cambridge, UK.
  • Wain LV; Department of Population Health Sciences, University of Leicester, Leicester, UK; NIHR Leicester Biomedical Research Center, Leicester, UK.
  • Evans RA; University Hospitals of Leicester NHS Trust & University of Leicester, Leicester, UK.
  • Brightling CE; University Hospitals of Leicester NHS Trust & University of Leicester, Leicester, UK.
  • Neubauer S; Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK.
  • McCann GP; University Hospitals of Leicester NHS Trust & University of Leicester, Leicester, UK.
  • Raman B; Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK. Electronic address: Betty.raman@cardiov.ox.ac.uk.
Int J Cardiol ; 415: 132415, 2024 Nov 15.
Article en En | MEDLINE | ID: mdl-39127146
ABSTRACT

BACKGROUND:

The role of ECG in ruling out myocardial complications on cardiac magnetic resonance (CMR) is unclear. We examined the clinical utility of ECG in screening for cardiac abnormalities on CMR among post-hospitalised COVID-19 patients.

METHODS:

Post-hospitalised patients (n = 212) and age, sex and comorbidity-matched controls (n = 38) underwent CMR and 12­lead ECG in a prospective multicenter follow-up study. Participants were screened for routinely reported ECG abnormalities, including arrhythmia, conduction and R wave abnormalities and ST-T changes (excluding repolarisation intervals). Quantitative repolarisation analyses included corrected QT (QTc), corrected QT dispersion (QTc disp), corrected JT (JTc) and corrected T peak-end (cTPe) intervals.

RESULTS:

At a median of 5.6 months, patients had a higher burden of ECG abnormalities (72.2% vs controls 42.1%, p = 0.001) and lower LVEF but a comparable cumulative burden of CMR abnormalities than controls. Patients with CMR abnormalities had more ECG abnormalities and longer repolarisation intervals than those with normal CMR and controls (82% vs 69% vs 42%, p < 0.001). Routinely reported ECG abnormalities had poor discriminative ability (area-under-the-receiver-operating curve AUROC) for abnormal CMR, AUROC 0.56 (95% CI 0.47-0.65), p = 0.185; worse among female than male patients. Adding JTc and QTc disp improved the AUROC to 0.64 (95% CI 0.55-0.74), p = 0.002, the sensitivity of the ECG increased from 81.6% to 98.0%, negative predictive value from 84.7% to 96.3%, negative likelihood ratio from 0.60 to 0.13, and reduced sex-dependence variabilities of ECG diagnostic parameters.

CONCLUSION:

Post-hospitalised COVID-19 patients have more ECG abnormalities than controls. Normal ECGs, including normal repolarisation intervals, reliably exclude CMR abnormalities in male and female patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Imagen por Resonancia Cinemagnética / Electrocardiografía / COVID-19 Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Malasia Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Imagen por Resonancia Cinemagnética / Electrocardiografía / COVID-19 Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Malasia Pais de publicación: Países Bajos