Background: Cardiac masses represent a heterogeneous clinical scenario. Potential electrocardiographic red flags of malignancy remain to be investigated. Objectives: To describe the spectrum of electrocardiographic abnormalities in a large cohort of cardiac masses and to evaluate potential red flags suggestive of malignancy. Methods: Observational cohort study of 322 consecutive patients with a cardiac mass and available ECG at Bologna University Hospital. All masses were diagnosed by histological examination or, in the case of cardiac thrombi, by radiological resolution after proper anticoagulant therapy. Multivariable regression analysis was used to assess potential predictors of malignancy among electrocardiographic abnormalities. All-cause mortality at follow-up was evaluated. Results: Of 322 patients, 98 (30.4%) had malignant tumors. Compared with patients with benign masses, those with malignant tumors exhibited a higher heart rate, right axis deviation, greater depolarization, repolarization abnormalities and bradyarrhythmia at presentation. Regarding specific ECG features, a higher heart rate on admission (p=0.014), bradyarrhythmias (p=0.009), ischemic-like repolarization abnormalities (ST-segment deviation, both depression and elevation, and negative T-wave; p<0.001), low voltages (p=0.001) and right axial deviation (0.025) were identified as independent predictors of malignancy. Considering these specific ECG alterations, a malignancy-oriented ECG was associated with higher mortality at follow up (median time of 20.7 months). Conclusion: ECG is frequently abnormal in case of malignant cardiac tumors. Some specific electrocardiographic changes are strongly suggestive for malignancy and type of infiltration.

Angeli, F., Bergamaschi, L., Paolisso, P., Armillotta, M., Sansonetti, A., Stefanizzi, A., et al. (2024). The Spectrum of ECG Abnormalities in a Large Cohort of Cardiac Masses. HEART RHYTHM, 22(1), 240-249 [10.1016/j.hrthm.2024.06.035].

The Spectrum of ECG Abnormalities in a Large Cohort of Cardiac Masses

Angeli, Francesco;Bergamaschi, Luca;Armillotta, Matteo;Sansonetti, Angelo;Stefanizzi, Andrea;Canton, Lisa;Bodega, Francesca;Suma, Nicole;Amicone, Sara;Fedele, Damiano;Bertolini, Davide;Impellizzeri, Andrea;Tattilo, Francesco Pio;Cavallo, Daniele;Di Iuorio, Ornella;Ryabenko, Khrystyna;Marinelli, Virginia;Alvarez, Marcello Casuso;Belà, Rebecca;Bavuso, Leonardo Luca;Asta, Claudio;Ciarlantini, Mariachiara;Pastore, Giuseppe;Rucci, Paola;Foa , Alberto;Pizzi, Carmine
2024

Abstract

Background: Cardiac masses represent a heterogeneous clinical scenario. Potential electrocardiographic red flags of malignancy remain to be investigated. Objectives: To describe the spectrum of electrocardiographic abnormalities in a large cohort of cardiac masses and to evaluate potential red flags suggestive of malignancy. Methods: Observational cohort study of 322 consecutive patients with a cardiac mass and available ECG at Bologna University Hospital. All masses were diagnosed by histological examination or, in the case of cardiac thrombi, by radiological resolution after proper anticoagulant therapy. Multivariable regression analysis was used to assess potential predictors of malignancy among electrocardiographic abnormalities. All-cause mortality at follow-up was evaluated. Results: Of 322 patients, 98 (30.4%) had malignant tumors. Compared with patients with benign masses, those with malignant tumors exhibited a higher heart rate, right axis deviation, greater depolarization, repolarization abnormalities and bradyarrhythmia at presentation. Regarding specific ECG features, a higher heart rate on admission (p=0.014), bradyarrhythmias (p=0.009), ischemic-like repolarization abnormalities (ST-segment deviation, both depression and elevation, and negative T-wave; p<0.001), low voltages (p=0.001) and right axial deviation (0.025) were identified as independent predictors of malignancy. Considering these specific ECG alterations, a malignancy-oriented ECG was associated with higher mortality at follow up (median time of 20.7 months). Conclusion: ECG is frequently abnormal in case of malignant cardiac tumors. Some specific electrocardiographic changes are strongly suggestive for malignancy and type of infiltration.
2024
Angeli, F., Bergamaschi, L., Paolisso, P., Armillotta, M., Sansonetti, A., Stefanizzi, A., et al. (2024). The Spectrum of ECG Abnormalities in a Large Cohort of Cardiac Masses. HEART RHYTHM, 22(1), 240-249 [10.1016/j.hrthm.2024.06.035].
Angeli, Francesco; Bergamaschi, Luca; Paolisso, Pasquale; Armillotta, Matteo; Sansonetti, Angelo; Stefanizzi, Andrea; Canton, Lisa; Bodega, Francesca;...espandi
File in questo prodotto:
Eventuali allegati, non sono esposti

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/1000279
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 2
  • ???jsp.display-item.citation.isi??? ND
social impact