Electrocardiographic Diagnosis of Hypertrophic Cardiomyopathy in the Pre- and Post-Diagnostic Phases in Children and Adolescents
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- Yoshinaga Masao
- Department of Pediatrics, National Hospital Organization Kagoshima Medical Center
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- Horigome Hitoshi
- Department of Child Health, Graduate School of Comprehensive Human Sciences, University of Tsukuba
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- Ayusawa Mamoru
- Department of Pediatrics, Nihon University Itabashi Hospital
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- Yasuda Kazushi
- Department of Pediatric Cardiology, Kids’ Heart Center, Aichi Children’s Health and Medical Center
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- Kogaki Shigetoyo
- Department of Pediatrics and Neonatology, Osaka General Medical Center
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- Doi Shozaburo
- Department of Pediatrics, National Hospital Organization Disaster Medical Center
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- Tateno Sigeru
- Department of Pediatrics, Chiba Kaihin Municipal Hospital
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- Ohta Kunio
- Department of Pediatrics, Kanazawa University
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- Hokosaki Tatsunori
- Department of Pediatrics, Yokohama City University Hospital
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- Nishihara Eiki
- Pediatric Cardiology, Ogaki Municipal Hospital
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- Iwamoto Mari
- Children’s Center, Saiseikai Yokohamashi Tobu Hospital
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- Sumitomo Naokata
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center
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- Ushinohama Hiroya
- Pediatric Cardiology, Ohori Children’s Clinic
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- Izumida Naomi
- Pediatric Cardiology, Akebonocho Clinic
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- Tauchi Nobuo
- Aichi Saiseikai Rehabilitation Hospital
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- Kato Yoshiaki
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center
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- Kato Taichi
- Department of Pediatrics/Developmental Pediatrics, Nagoya University Graduate School of Medicine
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- Chisaka Toshiyuki
- Pediatric Cardiology, Ehime University Graduate School of Medicine
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- Higaki Takashi
- Department of Regional Pediatrics and Perinatology, Ehime University Graduate School of Medicine
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- Yoneyama Tatsuya
- Fukuda Denshi Co., Ltd.
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- Abe Katsumi
- Tokyo Health Service Association
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- Nozaki Yoshihiro
- Department of Pediatrics, University of Tsukuba Hospital
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- Komori Akiko
- Department of Pediatrics and Child Health, Nihon University School of Medicine
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- Kawai Satoru
- Department of Pediatric Cardiology, Kids’ Heart Center, Aichi Children’s Health and Medical Center
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- Ninomiya Yumiko
- Department of Pediatrics, National Hospital Organization Kagoshima Medical Center
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- Tanaka Yuji
- Department of Pediatrics, National Hospital Organization Kagoshima Medical Center
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- Nuruki Norihito
- Department of Cardiovascular Medicine, National Hospital Organization Kagoshima Medical Center
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- Sonoda Masahiro
- Department of Cardiovascular Medicine, National Hospital Organization Kagoshima Medical Center
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- Ueno Kentaro
- Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences
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- Hazeki Daisuke
- Department of Pediatrics, Kagoshima City Hospital
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- Nomura Yuichi
- Department of Pediatrics, Kagoshima City Hospital
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- Sato Seiichi
- Department of Pediatric Cardiology, Okinawa Prefectural Nanbu Medical Center and Children’s Medical Center
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- Hirono Keiichi
- Department of Pediatrics, Faculty of Medicine, University of Toyama
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- Hosokawa Susumu
- Department of Pediatrics, Perinatal and Maternal Medicine, Tokyo Medical and Dental University
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- Takechi Fumie
- Department of Pediatrics, Chiba Cardiovascular Center
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- Ishikawa Yuichi
- Department of the Cardiovascular System, Fukuoka Children’s Hospital
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- Hata Tadayoshi
- Department of Pediatrics, Fujita Health University School of Medicine
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- Ichida Fukiko
- Department of Pediatrics, Sanno Hospital
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- Ohno Seiko
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center Research Institute
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- Makita Naomasa
- Omics Research Center, National Cerebral and Cardiovascular Center
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- Horie Minoru
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science
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- Matsushima Shouji
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
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- Tsutsui Hiroyuki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
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- Ogata Hiromitsu
- Graduate School of Kagawa Nutrition University
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- Takahashi Hideto
- Research Managing Director, National Institute of Public Health
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- Nagashima Masami
- Aichi Saiseikai Rehabilitation Hospital
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説明
<p>Background:The usefulness of electrocardiographic (ECG) voltage criteria for diagnosing hypertrophic cardiomyopathy (HCM) in pediatric patients is poorly defined.</p><p>Methods and Results:ECGs at the 1st grade (mean [±SD] age 6.6±0.3 years) were available for 11 patients diagnosed with HCM at around the 7th grade (13.2±0.3 years). ECGs were available for another 64 patients diagnosed with HCM in the 1st (n=15), 7th (n=32), and 10th (n=17) grades. Fifty-one voltage criteria were developed by grade and sex using 62,841 ECGs from the general population. Voltage criteria were set at the 99.95th percentile (1/2,000) point based on the estimated prevalence of childhood HCM (2.9 per 100,000 [1/34,483]) to decrease false negatives. Conventional criteria were from guidelines for school-aged children in Japan. Of 11 patients before diagnosis, 2 satisfied conventional criteria in 1st grade; 5 (56%) of the remaining 9 patients fulfilled 2 voltage criteria (R wave in limb-lead I [RI]+S wave in lead V3 [SV3] and R wave in lead V3 [RV3]+SV3). Robustness analysis for sensitivity showed RV3+SV3 was superior to RI+SV3. For all patients after diagnosis, RI+SV4 was the main candidate. However, conventional criteria were more useful than voltage criteria.</p><p>Conclusions:Early HCM prediction was possible using RV3+SV3 in >50% of patients in 1st grade. Voltage criteria may help diagnose prediagnostic or early HCM, and prevent tragic accidents, although further prospective studies are required.</p>
収録刊行物
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- Circulation Journal
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Circulation Journal 86 (1), 118-127, 2021-12-24
一般社団法人 日本循環器学会