Diagnostic Value of the Voltage-to-Mass Ratio in Biopsy-Proven Cardiac Amyloidosis

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Annals of Noninvasive Electrocardiology Pub Date : 2024-10-21 DOI:10.1111/anec.70026

Zihan Jiang, Shengsheng Zhuang, Min Tang, Zhuang Tian, Shuyang Zhang

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Abstract

Objectives

The calculation of left ventricular mass varies in different studies, and reference values of the voltage-to-mass ratio for diagnosing cardiac amyloidosis (CA) are lacking. This study aimed to determine the value of the voltage-to-mass ratio in diagnosing CA and provide an optimal cut-off value for different calculation methods.

Methods

We reviewed the electrocardiograms and echocardiograms of 213 consecutive biopsy-proven CA patients, 236 hypertrophic cardiomyopathy (HCM) patients, 100 hypertensive heart disease patients, and 181 healthy controls. Left ventricular mass was calculated using linear and cross-sectional area (CSA) methods. The voltage-to-mass ratios were compared between the CA group and other groups. The voltage-to-mass ratio obtained was used to build multivariate logistic regression models that predicted the log odds of developing CA.

Results

The CA group had a significantly lower voltage-to-mass ratio than the HCM, hypertensive heart disease, and healthy control groups. The voltage-to-mass ratio was an independent factor significantly associated with the CA diagnosis after adjusting for baseline characteristics. Linear and CSA methods yielded areas under the ROC curve of 0.86 and 0.90, respectively. Using the CSA method, the optimal cut-off was 16.42 mV/mm²/m², with 89.0% sensitivity and 80.8% specificity.

Conclusion

The voltage-to-mass ratio could differentiate patients with CA, HCM, and hypertensive heart disease from healthy controls, potentially providing an accurate and non-invasive alternative to current expensive and invasive diagnostic techniques.

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活组织检查证实的心脏淀粉样变性中电压-质量比的诊断价值

目的：不同研究对左心室质量的计算方法不尽相同，缺乏诊断心脏淀粉样变性（CA）的电压-质量比参考值。本研究旨在确定电压-质量比在诊断 CA 中的价值，并为不同的计算方法提供一个最佳临界值：我们对 213 名连续活检证实的 CA 患者、236 名肥厚型心肌病（HCM）患者、100 名高血压心脏病患者和 181 名健康对照者的心电图和超声心动图进行了复查。采用线性和横截面积（CSA）方法计算左心室质量。比较了 CA 组和其他组的电压-质量比。获得的电压-质量比被用于建立多变量逻辑回归模型，预测罹患 CA 的对数几率：结果：CA 组的电压质量比明显低于 HCM 组、高血压心脏病组和健康对照组。在调整基线特征后，电压质量比是与 CA 诊断显著相关的独立因素。线性法和 CSA 法的 ROC 曲线下面积分别为 0.86 和 0.90。使用 CSA 方法，最佳临界值为 16.42 mV/mm2/m2，敏感性为 89.0%，特异性为 80.8%：电压-质量比可将 CA、HCM 和高血压性心脏病患者与健康对照者区分开来，有望为目前昂贵的有创诊断技术提供一种准确、无创的替代方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Noninvasive Electrocardiology 医学-心血管系统

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation. ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.