Association of T-wave amplitude on electrocardiogram with left ventricular ejection fraction in children with dilated cardiomyopathy

Abstract:

Objective To study the association of T-wave amplitude on electrocardiogram (ECG) with left ventricular ejection fraction (LVEF) in children with dilated cardiomyopathy. Methods A retrospective analysis was performed for the clinical data of 44 children who were diagnosed with dilated cardiomyopathy from May 2009 to June 2018. According to LVEF, they were divided into two groups: LVEF ≥50% group (n=26) and LVEF <50% group (n=18). After treatment, 25 children were followed up for 3-42 months (mean 14±9 months). The Guangdong Zhongshan SR-1000A ECG Automatic Analyzer was used to obtain the 12-lead body surface ECG results in the supine position. T-wave amplitude on ECG was evaluated by software and manual measurement. Results Compared with the LVEF ≥50% group, the LVEF <50% group had a significant reduction in the T-wave amplitude in leads II, V₄, V₅ and V₆ (P < 0.05). The increased-LVEF group (an increase in LVEF>5% after treatment) had a significant increase in the T-wave amplitude in leads aVR, V₅, and V₆ after treatment (P < 0.05), while the unchanged-LVEF group (an increase in LVEF ≤ 5% after treatment) had a significant reduction in the T-wave amplitude in lead aVR after treatment (P < 0.05). The receiver operating characteristic curve analysis showed that the T-wave amplitude in leads II, V₄, V₅ and V₆ had a certain value in predicting LVEF <50% in children with dilated cardiomyopathy (P < 0.05). A combination of T-wave amplitude of ≤0.20 mV in lead II, ≤0.40 mV in lead V₄, and ≤0.30 mV in leads V₅ and V₆ had a sensitivity of 88.2% and specificity of 76.0% in the predication of LVEF <50% in children with dilated cardiomyopathy. Conclusions T-wave amplitude on ECG can be used as the indexes for the evaluation of the left ventricular systolic function in children with dilated cardio myopathy.