{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:39:33Z","timestamp":1760027973248,"version":"3.41.2"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,6,6]],"date-time":"2016-06-06T00:00:00Z","timestamp":1465171200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["#1R01HL118277"],"award-info":[{"award-number":["#1R01HL118277"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2017,1]]},"abstract":"Background<\/jats:title>A three\u2010dimensional electrocardiographic (ECG<\/jats:styled-content>) metric, the sum absolute QRST<\/jats:styled-content> integral (SAI QRST<\/jats:styled-content>), predicts ventricular arrhythmias in heart failure (HF<\/jats:styled-content>) patients with implantable cardioverter defibrillator and mechanical response to cardiac resynchronization therapy. We hypothesized that there is an association between patient\u2010specific changes in SAI QRST<\/jats:styled-content> and myocardial injury as measured by high\u2010sensitivity troponin I (hsTnI).<\/jats:p><\/jats:sec>Methods<\/jats:title>Sum absolute integral QRST<\/jats:styled-content> on resting 12\u2010lead ECG<\/jats:styled-content> and hsTnI were measured simultaneously, every 3 hours, and during 12\u2010hour observation period in a prospective cohort of emergency department patients (n = 398; mean age 57.8 \u00b1 13.2 years; 54% female, 64% black), diagnosed with acute coronary syndrome (ACS<\/jats:styled-content>, n = 28), acutely decompensated HF<\/jats:styled-content> (acute decompensated heart failure<\/jats:styled-content>, n = 35), cardiac non\u2010ACS<\/jats:styled-content> (n = 19), or noncardiac condition (n = 316). Random\u2010effects linear regression analysis assessed the association of SAI QRST<\/jats:styled-content> and myocardial injury, with adjustment for demographics (age, sex, race), prevalent cardiovascular disease (myocardial infarction, history of revascularization, stroke, and HF<\/jats:styled-content>), risk factors (diabetes, smoking, hypercholesterolemia, hypertension, and cocaine use), and left bundle branch block.<\/jats:p><\/jats:sec>Results<\/jats:title>Within the entire cohort, SAI QRST<\/jats:styled-content> decreased by 3 (95%CI<\/jats:styled-content> \u22125 to \u22121) mV<\/jats:styled-content>*ms every 3 hours. A 10\u2010fold increase in hsTnI was associated with a 7.7 (0.6\u201314.9) mV<\/jats:styled-content>*ms increase in SAI QRST<\/jats:styled-content>. In the subgroup of acutely decompensated HF<\/jats:styled-content> patients (n = 35), a 10\u2010fold increase in hsTnI was associated with a 61.0 (5.9\u2013116.1) mV<\/jats:styled-content>*ms increase in SAI<\/jats:styled-content> QRST.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Patient\u2010specific time\u2010varying changes in the surface ECG<\/jats:styled-content> scalar measure of global electrical heterogeneity, as measured by SAI QRST<\/jats:styled-content>, and in myocardial injury as measured by hsTnI, are independently and directly associated with each other, likely reflecting a common underlying mechanism.<\/jats:p><\/jats:sec>","DOI":"10.1111\/anec.12379","type":"journal-article","created":{"date-parts":[[2016,6,6]],"date-time":"2016-06-06T05:32:45Z","timestamp":1465191165000},"source":"Crossref","is-referenced-by-count":5,"title":["Dynamic Changes in High\u2010Sensitivity Cardiac Troponin I Are Associated with Dynamic Changes in Sum Absolute QRST<\/scp> Integral on Surface Electrocardiogram in Acute Decompensated Heart Failure"],"prefix":"10.1111","volume":"22","author":[{"given":"Larisa G.","family":"Tereshchenko","sequence":"first","affiliation":[{"name":"The Division of Cardiology Department of Medicine Johns Hopkins Hospital Baltimore MD USA"},{"name":"Knight Cardiovascular Institute Oregon Health & Science University Portland OR USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert","family":"Feeny","sequence":"additional","affiliation":[{"name":"Whiting School of Engineering The Johns Hopkins University Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica","family":"Shelton","sequence":"additional","affiliation":[{"name":"The Emergency Medicine Department Johns Hopkins Hospital Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Metkus","sequence":"additional","affiliation":[{"name":"The Division of Cardiology Department of Medicine Johns Hopkins Hospital Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Stolbach","sequence":"additional","affiliation":[{"name":"The Emergency Medicine Department Johns Hopkins Hospital Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernest","family":"Mavunga","sequence":"additional","affiliation":[{"name":"The Emergency Medicine Department Johns Hopkins Hospital Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shannon","family":"Putman","sequence":"additional","affiliation":[{"name":"The Emergency Medicine Department Johns Hopkins Hospital Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick K.","family":"Korley","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Michigan Health Systems Ann Arbor MI 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