The Neonatal QRS Complex and Its Association with Left Ventricular Mass
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The Neonatal QRS Complex and Its Association with Left Ventricular Mass. / Molin, Julie; Hartmann, Joachim; Pærregaard, Maria Munk; Thygesen, Caroline Boye; Sillesen, Anne Sophie; Raja, Anna Axelsson; Vøgg, Ruth Ottilia Birgitta; Iversen, Kasper Karmark; Bundgaard, Henning; Christensen, Alex Hørby.
In: Pediatric Cardiology, Vol. 45, No. 2, 2024, p. 248-256.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - The Neonatal QRS Complex and Its Association with Left Ventricular Mass
AU - Molin, Julie
AU - Hartmann, Joachim
AU - Pærregaard, Maria Munk
AU - Thygesen, Caroline Boye
AU - Sillesen, Anne Sophie
AU - Raja, Anna Axelsson
AU - Vøgg, Ruth Ottilia Birgitta
AU - Iversen, Kasper Karmark
AU - Bundgaard, Henning
AU - Christensen, Alex Hørby
N1 - Publisher Copyright: © 2023, The Author(s).
PY - 2024
Y1 - 2024
N2 - To evaluate QRS complex features during the first month of life and the association with echocardiographic measurements of left ventricular mass in neonates. Prospective cohort study of neonates with electrocardiography (ECG) and echocardiography performed during the first month of life. Left ventricular mass index (LVMI) was determined by echocardiography and the correlation with electrocardiographic markers of LVMI outliers (≥ 98th percentile) were analyzed. We included 17,450 neonates (52% boys; median age at examination 11 days) and found an increase in median QRS duration and LVMI during the first month of life (54 vs. 56 ms and 24.7 vs. 28.6 g/m2 at days 0–4 and 25–30, respectively; both p < 0.001). All investigated ECG features (QRS duration, QRS area in V1/V6, maximum amplitudes of S-V1/R-V6, and the Sokolow–Lyon voltage product) showed no to low correlation with LVMI, resulting in low sensitivities (0–9.0%), but high specificities (97.2–98.1%), and area under the curve values close to the identity line (0.49–0.61) for identifying LVMI outliers. Adjustment of outlier definition for LVMI and threshold for QRS features had no significant effect on sensitivity. We present reference values for QRS complex features and their association with LVMI in neonates from a large, unselected, population-based cohort. The QRS complex gradually evolved during the first month of life but had a low correlation with LVMI. Our results indicate a poor diagnostic value of using ECG features to identify LVMI outliers in neonates. Trial Registry Copenhagen Baby Heart, NCT02753348, https://clinicaltri-als.gov/ct2/show/NCT02753348?cond=Copenhagen+Baby+Heart&draw=2&rank=1 , deidentified individual participant data will not be made available.
AB - To evaluate QRS complex features during the first month of life and the association with echocardiographic measurements of left ventricular mass in neonates. Prospective cohort study of neonates with electrocardiography (ECG) and echocardiography performed during the first month of life. Left ventricular mass index (LVMI) was determined by echocardiography and the correlation with electrocardiographic markers of LVMI outliers (≥ 98th percentile) were analyzed. We included 17,450 neonates (52% boys; median age at examination 11 days) and found an increase in median QRS duration and LVMI during the first month of life (54 vs. 56 ms and 24.7 vs. 28.6 g/m2 at days 0–4 and 25–30, respectively; both p < 0.001). All investigated ECG features (QRS duration, QRS area in V1/V6, maximum amplitudes of S-V1/R-V6, and the Sokolow–Lyon voltage product) showed no to low correlation with LVMI, resulting in low sensitivities (0–9.0%), but high specificities (97.2–98.1%), and area under the curve values close to the identity line (0.49–0.61) for identifying LVMI outliers. Adjustment of outlier definition for LVMI and threshold for QRS features had no significant effect on sensitivity. We present reference values for QRS complex features and their association with LVMI in neonates from a large, unselected, population-based cohort. The QRS complex gradually evolved during the first month of life but had a low correlation with LVMI. Our results indicate a poor diagnostic value of using ECG features to identify LVMI outliers in neonates. Trial Registry Copenhagen Baby Heart, NCT02753348, https://clinicaltri-als.gov/ct2/show/NCT02753348?cond=Copenhagen+Baby+Heart&draw=2&rank=1 , deidentified individual participant data will not be made available.
KW - Electrocardiography
KW - Left ventricular mass
KW - Neonates
KW - QRS complex
KW - Reference values
U2 - 10.1007/s00246-023-03361-0
DO - 10.1007/s00246-023-03361-0
M3 - Journal article
C2 - 38151605
AN - SCOPUS:85180718060
VL - 45
SP - 248
EP - 256
JO - Pediatric Cardiology
JF - Pediatric Cardiology
SN - 0172-0643
IS - 2
ER -
ID: 381681532