Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Owsianka, N; Schober, L; Sallmon, H; Scherr, D; Köstenberger, N; Manninger, M; Öffl, N; Kurath-Koller, S.
Electrocardiographic markers of hypertrophy in children: revisiting R/S overlap and the Katz-Wachtel phenomenon.
Front Pediatr. 2025; 13:1713053
Doi: 10.3389/fped.2025.1713053
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- Führende Autor*innen der Med Uni Graz
- Manninger-Wünscher Martin
- Owsianka Nikola
- Co-Autor*innen der Med Uni Graz
- Kurath-Koller Stefan
- Öffl Nathalie Maria
- Sallmon Hannes
- Scherr Daniel
- Schober Lukas
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- Abstract:
- BACKGROUND: Many children show R/S overlap in ECG chest leads. The Katz-Wachtel phenomenon, described in the 1960s, characterizes high R and S waves ≥50 mm as an ECG feature of biventricular cardiac hypertrophy. This study investigates the KWP and the association between an R/S overlap and cardiac hypertrophy. METHODS: Retrospective study including 800 pediatric patients, treated at the Division of Pediatric Cardiology, University Hospital Graz, between 2016 and 2022. ECG measurements with regard to R/S overlap and voltage in chest leads and review of echocardiography findings of cardiac hypertrophy. ECG measurements were manually obtained and reviewed by two blinded pediatric cardiologists. RESULTS: Of the 500 patients with an R/S overlap, 4% had confirmed cardiac hypertrophy compared to 1% of children without confirmed R/S overlap. Sensitivity was highest in leads V3/4 (69%), while specificity was highest in leads V1/V2 (93%) and V5/V6 (96%), respectively. A statistically significant correlation between R/S overlap and hypertrophy was found. CONCLUSION: R/S overlap correlates with myocardial hypertrophy in children. While it demonstrates high sensitivity, its limited specificity prevents its use as a standalone diagnostic parameter. It may contribute to early identification when combined with other ECG features and echocardiographic evaluation.
- Find related publications in this database (Keywords)
- ECG
- children
- ventricular hypertrophy
- chest leads
- Katz-Wachtel-Phenomenon
- biventricular hypertrophy
- electrocardiography