Electrocardiogram signs of right ventricular hypertrophy may help identify pulmonary hypertension in patients with dilated cardiomyopathy. (March 2019)

• Record Type: Journal Article
• Authors: Chen, Chengzhi; Liu, Jingyan; Liu, Zhiyong; He, Xin; Yuan, Xuming; Ouyang, Xiufen; Wang, Lei; Li, Xiaoping
• Is Part Of: IJC heart & vasculature. Volume 22(2019)
• Page Start: 61
• Page End: 66
• Publication Date: 2019-03
• Subjects: BUN blood urea nitrogen -- CO cardiac output -- DBP diastolic blood pressure -- DCM dilated cardiomyopathy -- ECG electrocardiogram -- LAD left atrial diameter -- LHD left heart disease -- LVEDD left ventricular end diastolic Diameter -- LVEF left ventricular ejection fraction -- NPV negative predictive values -- NT pro-BNP N-terminal fragment pro-brain natriuretic peptide -- NYHA New York Heart Association -- mPAP mean pulmonary artery pressure -- PA pulmonary arterial -- PASP pulmonary artery systolic pressure -- PAWP pulmonary capillary wedge pressure -- PH pulmonary hypertension -- PPV positive predictive values -- PVR pulmonary vascular resistance -- RHC right heart catheterization -- RVEDD right ventricle end diastolic diameter -- RVH right ventricular hypertrophy -- SBP systolic blood pressure -- TPG transpulmonary gradient; Dilated cardiomyopathy -- Pulmonary hypertension -- Right ventricular hypertrophy -- ECG; Cardiovascular system -- Diseases -- Periodicals; Cardiovascular system -- Pathophysiology -- Periodicals; 616.1005
• DOI: 10.1016/j.ijcha.2018.12.006
• Languages: English
• ISSNs: 2352-9067

Abstract

Abstract: Objective: To the authors' knowledge, limited data are available regarding the association between Electrocardiogram (ECG) signs of right ventricular hypertrophy (RVH) and pulmonary hypertension (PH) in patients with dilated cardiomyopathy (DCM). We aimed to assess the accuracy of the recommended ECG criteria of RVH for predicting PH in patients with DCM. Methods: According to the definition of PH (mPAP ≥ 25 mm Hg), 35 patients with DCM were divided into 2 groups: DCM with PH (n = 22) and DCM without PH (n = 13). Right heart catheterization was performed in all patients. Seventeen parameters of RVH recommended by the AHA/ACCF/HRS for diagnosis of RVH on ECG were determinded. Results: The following parameters were correlated with mPAP: RV1 > 6 mm, SV5 > 10 mm, R:SV6 < 0.4, RV1 + SV5 or V6 > 10.5 mm and PII amplitude. The following parameters were significantly different between DCM patients with and without PH: S in V5 (SV5 ) > 10 mm, S in V6 (SV6 ) > 3 mm, R:S ratio in V5 (R:SV5 ) < 0.75, RV1 + SV5 or V6 > 10.5 mm, S > R inI, S > R inII and R:SV1 > R:SV3, although results were no longer significant after correcting for multiple comparisons. High specificity (92.3–100%), lowsensitivity (31.8–50%), high positive predictive value, and low negative predictive value of established parameters of RVH were noted for predicting PH in patients with DCM. Conclusion: Several ECG signs of RVH may be useful for in the diagnosis PH in patients with DCM.