{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:01:53Z","timestamp":1785283313796,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,8,20]],"date-time":"2018-08-20T00:00:00Z","timestamp":1534723200000},"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","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL122492"],"award-info":[{"award-number":["R01HL122492"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL126938"],"award-info":[{"award-number":["R01HL126938"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008723","name":"Suomen L\u00e4\u00e4ketieteen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008723","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005633","name":"Syd\u00e4ntutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007083","name":"Orionin Tutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007083","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003756","name":"Biomedicum Helsinki-s\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003756","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2018,11]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Early diagnosis and therapy improves outcomes in heart failure with severely reduced left ventricular ejection fraction (LVEF<\/jats:styled-content> \u226435%), but some patients may remain undiagnosed. We hypothesized that a combination of electrocardiogram (ECG<\/jats:styled-content>) markers may identify individuals with severely reduced LVEF<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>From a community\u2010based study in the Northwest US<\/jats:styled-content> (the Oregon Sudden Unexpected Death Study), we evaluated the prevalence of conventional ECG<\/jats:styled-content> markers by LVEF<\/jats:styled-content>. We then evaluated the association of nine additional ECG<\/jats:styled-content> markers and LVEF<\/jats:styled-content>. We validated the correlation of these ECG<\/jats:styled-content> markers and LVEF<\/jats:styled-content> in a separate, large health system in Los Angeles, California.<\/jats:p><\/jats:sec>Results<\/jats:title>In the discovery population (n<\/jats:italic>\u00a0=\u00a01,047), patients with LVEF<\/jats:styled-content> \u226435% were twice as likely as those with LVEF<\/jats:styled-content> >35% to have \u22651 conventional ECG<\/jats:styled-content> abnormality. In the subset without conventional ECG<\/jats:styled-content> abnormalities, \u22654 abnormal ECG<\/jats:styled-content> markers from the expanded panel were found in 12% vs. 1% of patients with LVEF<\/jats:styled-content> \u226435% and >35%, respectively. In the validation population (n<\/jats:italic>\u00a0=\u00a09,742), 44% with LVEF<\/jats:styled-content> \u226435% and 17% with LVEF<\/jats:styled-content> >35% had \u22651 conventional ECG<\/jats:styled-content> abnormality. In patients without conventional ECG<\/jats:styled-content> abnormalities (n<\/jats:italic>\u00a0=\u00a07,601), 40% with LVEF<\/jats:styled-content> \u226435% and 5% with LVEF<\/jats:styled-content> >35% had \u22654 abnormal ECG<\/jats:styled-content> markers from the expanded panel. Each additional abnormal ECG<\/jats:styled-content> marker from the expanded panel (range 0 to \u22654) more than doubled the odds of LVEF<\/jats:styled-content> \u226435%.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>An expanded panel of easily obtained ECG<\/jats:styled-content> markers correlated strongly with severely reduced LVEF<\/jats:styled-content> in two separate populations. This electrical surrogate score could facilitate diagnosis of severely reduced LVEF<\/jats:styled-content>, and warrants prospective evaluation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/anec.12591","type":"journal-article","created":{"date-parts":[[2018,8,20]],"date-time":"2018-08-20T12:38:13Z","timestamp":1534768693000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Electrical surrogate for detection of severe left ventricular systolic dysfunction"],"prefix":"10.1111","volume":"23","author":[{"given":"Kyndaron","family":"Reinier","sequence":"first","affiliation":[{"name":"Heart Institute Cedars\u2010Sinai Medical Center Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aapo L.","family":"Aro","sequence":"additional","affiliation":[{"name":"Heart Institute Cedars\u2010Sinai Medical Center Los Angeles California"},{"name":"Heart and Lung Center Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Uy\u2010Evanado","sequence":"additional","affiliation":[{"name":"Heart Institute Cedars\u2010Sinai Medical Center Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Rusinaru","sequence":"additional","affiliation":[{"name":"Heart Institute Cedars\u2010Sinai Medical Center Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harpriya S.","family":"Chugh","sequence":"additional","affiliation":[{"name":"Heart Institute Cedars\u2010Sinai Medical Center Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Shiota","sequence":"additional","affiliation":[{"name":"Heart Institute Cedars\u2010Sinai Medical Center Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Jui","sequence":"additional","affiliation":[{"name":"Oregon Health and Science University Portland Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4417-5326","authenticated-orcid":false,"given":"Sumeet S.","family":"Chugh","sequence":"additional","affiliation":[{"name":"Heart Institute Cedars\u2010Sinai Medical Center Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.115.003629"},{"key":"e_1_2_8_3_1","first-page":"629","article-title":"Cardiac structural and functional profile of patients with delayed qrs transition zone and sudden cardiac death","volume":"19","author":"Aro A. 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