ECG alterations suggestive of hyperkalemia in normokalemic versus hyperkalemic patients

SUMMARYThe prevalence of cardiac morbidity due to Change' disease was assessed in a rural community in Central Bolivia. Sixty-nine of 104 persons (66%) were seropositive to Trypanosoma cruzi by two serological methods. Two of 35 (6%) seronegative individuals presented with modest ECG alterations (left anterior hemiblock), but 21 of 69 (30%) seropositives showed modest and severe abnormalities (6 complete right bundle branch block. 2 polyfocal or frequent extrasystoles, 9 ischaemic ST alterations). A high percentage (56%) of domiciliary Triatoma infestans was infected with T. cruzi. There was a significant association between seropositivity and substandard housing. Priority preventive measures should thus include house improvement (to reduce bug infestation) and health education.

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Relation of clinical symptoms, ECG alterations and serum levels by the toxicological examination of an antiarrhitmic compound on beagle dogs

Toxicology Letters ◽

10.1016/0378-4274(94)90467-7 ◽

1994 ◽

Vol 74 ◽

pp. 94

Author(s):

J. Wellmann ◽

T. Szalai ◽

É. Tomori ◽

L. Vereczkey

Keyword(s):

Clinical Symptoms ◽

Serum Levels ◽

Beagle Dogs ◽

Ecg Alterations

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383 ECG in biopsy-proven and clinically suspected myocarditis: morpho-functional correlates and prognostic implications

European Heart Journal Supplements ◽

10.1093/eurheartj/suab142.019 ◽

2021 ◽

Vol 23 (Supplement_G) ◽

Author(s):

Andrea Silvio Giordani ◽

Alex Panzarella ◽

Andrea Candelora ◽

Davide Marcolongo ◽

Chiara Merola ◽

...

Keyword(s):

Nyha Class ◽

Left Ventricular ◽

Long Qt ◽

Bundle Branch Block ◽

Entire Cohort ◽

Surrogate Outcome ◽

Wave Inversion ◽

Significant Difference ◽

Ecg Alterations

Abstract Aims A distinction exists between biopsy-proven (BP) and clinically suspected (CS) myocarditis, the latter being an exclusion diagnosis based on clinical and instrumental findings. A clear diagnostic and prognostic role of the ECG in these two groups of patients has not yet been defined. (i) To describe frequency and characteristics of ECG findings in myocarditis, and to assess any difference between CS and BP myocarditis; (2) to identify morpho-functional correlates between ECG and cardiac magnetic resonance (CMR); and (iii) to evaluate the prognostic value of ECG findings. Methods and results 162 patients were included (median age 36 years, 70% male, median follow-up 32.9 months), 36 with BP and 126 with CS myocarditis. All patients underwent CMR; for ECG-CMR correlates, the ECG nearest in time to CMR was assessed. Surrogate outcome was defined as left ventricular (LV) ejection fraction (EF) <50% and/or NYHA class >I during follow-up. In the entire cohort ECG alterations were numerous: T-wave inversion (TWI) (82%), fragmented QRS (34%), low voltages (14%), ST elevation (STE) (13%). Compared to CS myocarditis, BP myocarditis patients showed higher frequency of non-sinus rhythm (17% vs. 2%, P < 0.001), long QT (28% vs. 0%, P < 0.001), lateral TWI (36% vs. 19%, P = 0.031) and bundle branch block (19% vs. 2%, P < 0.001). BP myocarditis patients had worse clinical features at diagnosis: heart failure (64% vs. 6%, P < 0.001), arrhythmic (14% vs. 4%, P = 0.029) and fulminant presentation (14% vs. 0%, P < 0.001), and presented higher LV end-diastolic volume and lower LVEF by echocardiography and CMR (109.5 mL/m2 vs. 85.50 ml/m2, P < 0.001; 31.5% vs. 59%, P < 0.001). A correlation was observed between number of myocardial segments with oedema at CMR and low ECG voltages (P = 0.010) and between late gadolinium enhancement (LGE) mass at CMR and lateral STE (P = 0.004 and P = 0.049, respectively). Several ECG alterations correlated with the surrogate outcome: long QT (P = 0.029), lateral TWI (P = 0.006), left bundle branch block (P < 0.001), ventricular ectopic beats (P = 0.020), and atrial fibrillation (P < 0.001). Conclusions A significant difference in ECG findings between CS and BP myocarditis has been demonstrated: ECG alterations are more frequent and more severe in BP myocarditis and correlate with prognosis. Moreover, ECG alterations identified patients with pathologic morpho-functional correlates.

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J-waves in acute COVID-19: A novel disease characteristic and predictor of mortality?

PLoS ONE ◽

10.1371/journal.pone.0257982 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0257982

Author(s):

Naufal Shamilevich Zagidullin ◽

Lukas J. Motloch ◽

Timur Ilgamovich Musin ◽

Zilya Adibovna Bagmanova ◽

Irina Alexandrovna Lakman ◽

...

Keyword(s):

Cox Regression ◽

Independent Predictor ◽

Common Finding ◽

History Of ◽

Ecg Alterations ◽

Ventricular Tachycardias ◽

Disease Characteristic ◽

Wave Incidence ◽

J Wave

Background J-waves represent a common finding in routine ECGs (5–6%) and are closely linked to ventricular tachycardias. While arrhythmias and non-specific ECG alterations are a frequent finding in COVID-19, an analysis of J-wave incidence in acute COVID-19 is lacking. Methods A total of 386 patients consecutively, hospitalized due to acute COVID-19 pneumonia were included in this retrospective analysis. Admission ECGs were analyzed, screened for J-waves and correlated to clinical characteristics and 28-day mortality. Results J-waves were present in 12.2% of patients. Factors associated with the presence of J-waves were old age, female sex, a history of stroke and/or heart failure, high CRP levels as well as a high BMI. Mortality rates were significantly higher in patients with J-waves in the admission ECG compared to the non-J-wave cohort (J-wave: 14.9% vs. non-J-wave 3.8%, p = 0.001). After adjusting for confounders using a multivariable cox regression model, the incidence of J-waves was an independent predictor of mortality at 28-days (OR 2.76 95% CI: 1.15–6.63; p = 0.023). J-waves disappeared or declined in 36.4% of COVID-19 survivors with available ECGs for 6–8 months follow-up. Conclusion J-waves are frequently and often transiently found in the admission ECG of patients hospitalized with acute COVID-19. Furthermore, they seem to be an independent predictor of 28-day mortality.

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Contribution of Platelets to the Cardiovascular Effects of ADP in the Rat

Thrombosis and Haemostasis ◽

10.1055/s-0038-1646663 ◽

1978 ◽

Vol 39 (01) ◽

pp. 135-145 ◽

Cited By ~ 7

Author(s):

Elisabetta Dejana ◽

Maria Grazia Castelli ◽

Giovanni De Gaetano ◽

Aurora Bonaccorsi

Keyword(s):

Blood Pressure ◽

Platelet Aggregation ◽

Cardiovascular Effects ◽

Ecg Changes ◽

Experimental Conditions ◽

Rapid Injection ◽

Blood Pressure Fall ◽

Ectopic Beats ◽

Ecg Alterations ◽

Pressure Fall

SummaryThe contribution of platelets to the cardiovascular effects of ADP was investigated in rats in different experimental conditions. Following rapid i. v. bolus injections of ADP (from 0.001 to 0.03 mg/kg b. w.) only a dose-related fall in blood pressure could be detected. Increasing the dose of ADP (up to 1 mg/kg b. w.), platelet fall and changes in cardiac rhythm (bradycardia, A. V. blocks and ectopic beats) became evident. All these phenomena were rapidly reversed. Inhibition of platelet aggregation by a pyrimido-pyrimidine compound (SH 869) or thrombocytopenia induced by Busulfan or antiplatelet antiserum did not significantly protect the animals from the cardiovascular effects of ADP. The fall in blood pressure, however, was reduced. Adenosine, at equimolar concentrations, caused ECG changes similar to those induced by ADP with no platelet aggregation and a less pronounced blood pressure fall.These results suggest that most of the cardiovascular modifications induced by rapid injection of ADP are largely independent of platelets. Platelets appeared to play a more important role when ADP was given for a longer period of time. A slow i. v. infusion of ADP (6 mg/kg b. w. for 10 min) was accompanied by platelet fall, cardiovascular collapse and ECG alterations typical of myocardial ischaemia. All these effects persisted throughout the ADP infusion but disappeared soon after its termination. They were almost completely inhibited in rats given SH 869 or made thrombocytopenic.In conclusion, platelets seem to contribute to the cardiovascular effects of ADP only in certain experimental conditions. In others, the nucleotide’s direct effects seem more important.

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