{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T13:28:16Z","timestamp":1770038896515,"version":"3.49.0"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,7,11]],"date-time":"2021-07-11T00:00:00Z","timestamp":1625961600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Heart disease remains a leading cause of mortality in patients with muscular dystrophy (MD), and cardiac assessment by standard imaging modalities is challenging due to the prominence of physical limitations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective cohort study of 169\u00a0MD patients and 34 negative control patients, we demonstrate the clinical utility of a 12\u2010lead electrocardiogram (ECG) as an effective modality for the assessment of cardiac status in patients with MD. We assessed the utility of conventional criteria for electrocardiogram\u2010indicated left ventricular hypertrophy (ECG\u2010LVH) as well as ECG morphologies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cornell voltage, Cornell voltage\u2010duration, Sokolow\u2013Lyon voltage, and Romhilt\u2010Estes point score criteria demonstrated low sensitivity and minimal positive predictive value for ECG\u2010LVH when compared with cardiac imaging. Patients with LBBB had a high probability of a cardiomyopathy (relative risk [RR], 2.75; 95% confidence interval [CI], 2.14\u20133.53; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001), and patients with QRS fragmentation (fQRS) had a high probability of a cardiomyopathy (RR, 1.76; 95% CI, 1.20\u20132.59; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.004), requiring cardiac medication and device intervention. We found that an R\/S ratio &gt;1 in V1 and V2 is highly specific (specificity, 0.89; negative predictive value [NPV], 0.89 and specificity, 0.82; NPV, 0.89, respectively) for patients with dystrophinopathies compared with other types of MD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The identification of LBBB and fQRS was linked to cardiomyopathy in patients with MD, while ECG\u2010LVH was of limited utility. Importantly, these findings can be applied to effectively screen a broad cohort of MD patients for structural heart disease and prompt further evaluation and therapeutic intervention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/anec.12876","type":"journal-article","created":{"date-parts":[[2021,7,12]],"date-time":"2021-07-12T04:25:38Z","timestamp":1626063938000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical utility of 12\u2010lead electrocardiogram in evaluating heart disease in patients with muscular dystrophy: Assessment of left ventricular hypertrophy, conduction disease, and cardiomyopathy"],"prefix":"10.1111","volume":"26","author":[{"given":"Anish","family":"Nikhanj","sequence":"first","affiliation":[{"name":"Division of Cardiology"},{"name":"Mazankowski Alberta Heart Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haran","family":"Yogasundaram","sequence":"additional","affiliation":[{"name":"Division of Cardiology"},{"name":"Mazankowski Alberta Heart Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shane","family":"Kimber","sequence":"additional","affiliation":[{"name":"Division of Cardiology"},{"name":"Mazankowski Alberta Heart Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaeem A.","family":"Siddiqi","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine University of Alberta Edmonton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9154-9028","authenticated-orcid":false,"given":"Gavin Y.","family":"Oudit","sequence":"additional","affiliation":[{"name":"Division of Cardiology"},{"name":"Mazankowski Alberta Heart Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,7,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.115.003629"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhj.2002.121264"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542\u2010474X.1997.tb00325.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12604"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcha.2018.12.006"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246\u2010017\u20101616\u20107"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.107.763284"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1542\u2010474x.2003.08413.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540\u20108167.2002.00444.x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2016.00653"},{"key":"e_1_2_10_12_1","first-page":"694","article-title":"Bazett's QT correction reviewed: Evidence that a linear QT correction for heart rate is better","volume":"1","author":"Hodges M. 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