Open AccessElectrocardiographic appearance of aortic stenosis before and after aortic valve replacement
Author(s) -
Vranic Ivana I.
Publication year - 2017
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12457
Subject(s) - medicine , cardiology , asymptomatic , stenosis , qrs complex , aortic valve replacement , precordial examination , hemodynamics , clinical significance , statistical significance , diastole , aortic valve , electrocardiography , blood pressure
Background So far, the specific appearance of QRS complex, ST ‐segment, and T wave was observed in aortic stenosis ( AS ). S‐wave dynamic change in leads V 1 –V 3 was not reported in AS . Methods In a single‐center, prospective study, we included a total number of 1.175 patients who underwent surgical aortic valve replacement ( AVR ). We conducted 3‐year gathering of patients with symptomatic and asymptomatic severe AS , and separated them by hemodynamic stability into groups A and B, through EFLV (of more or less than 50%), AVA (of more or less than 0.9 cm 2 ), PG (between 55 and 75 mm Hg or over 75 mm Hg), and end‐diastolic LV dimension (of more or less than 56 mm). We evaluated the impact of S‐wave magnitude in right precordial leads before and after AVR in all patients. We followed S‐wave changes in electrocardiogram altogether with hemodynamic measurements derived from echocardiography. Results Analysis of echocardiographic parameters, measured in patients before surgery, did not show statistical significance between asymptomatic and symptomatic group. The statistical significance was observed in the change in S‐wave magnitude in the right precordial leads in both subsets of patients before AVR . We found statistically significant predictive value of S‐wave magnitude in leads V 2 –V 3 for dependent variables PG and end‐diastolic LV dimension. Conclusions S‐wave changes in right precordial leads can predict increase in PG and critical narrowing of AVA , suggestive of timely referral for AVR .