Deeper S Wave in Lead V5 and Broader Extent of T Wave Inversions in the Precordial Leads are Clinically Useful Electrocardiographic Parameters for Predicting Pulmonary Hypertension
Deeper S Wave in Lead V5 and Broader Extent of T Wave Inversions in the Precordial Leads are Clinically Useful Electrocardiographic Parameters for Predicting Pulmonary Hypertension
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DOI：
10.1536/ihj.16-647
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发表时间：
2018-01-01
影响因子：
1.5
通讯作者：
Maemura, Koji
中科院分区：
文献类型：
--
作者：
Miura, Miyuki;Ikeda, Satoshi;Maemura, Koji
心电图（ECG）用于筛查肺动脉高压（PH）。在145例疑似PH并接受右心导管插入术（RHC）的受试者（年龄58.4 ± 17.5岁，112名女性，平均肺动脉压[MPAP] 35.4 ± 13.3 mmHg）的ECG中检查了与右心室肥大标准相关的ECG参数。根据RHC结果，108名受试者患有PH（56名肺动脉高压[PAH]和52名慢性血栓栓塞性肺动脉高压[CTEPH]），在本研究的17个ECG参数中，有14个在单因素分析中与PH显著相关。多因素Logistic回归分析，V5导联S波深度（比值比[OR] 1.25，95%置信区间[CI] 1.10-1.47）和V4导联T波倒置深度（OR 1.21，95% CI 1.03-1.46）是MPAP >= 25 mmHg的独立预测因子，受试者工作特征曲线分析确定的截止值分别为0.42 mV和-0.28 mV。总之，V5导联S波较深和心前区导联T波较宽可能是临床上筛选PH的简单而有用的ECG参数。
Electrocardiography (ECG) is used to screen for pulmonary hypertension (PH). However, it is unclear which parameters of ECG are the most useful for screening.ECG parameters related to right ventricular hypertrophy criteria were examined in 145 ECGs of subjects who were suspected to have PH and underwent right heart catheterization (RHC) (age 58.4 +/- 17.5 years, 112 women, mean pulmonary arterial pressure [MPAP] 35.4 +/- 13.3 mmHg). Based on the results of RHC, 108 subjects had PH (56 pulmonary arterial hypertension [PAH] and 52 chronic thromboembolic pulmonary hypertension [CTEPH]).Fourteen of 17 ECG parameters in the present study were significantly associated with PH on univariate analysis. On multivariable logistic regression analysis, S wave depth in lead V5 (odds ratio [OR] 1.25, 95% confidence interval [CI] 1.10-1.47) and depth of T wave inversion in lead V4 (OR 1.21, 95% CI 1.03-1.46) were independent predictors of MPAP >= 25 mmHg, and the cut-off values determined by receiver operating characteristic curve analyses were 0.42 mV and -0.28 mV, respectively.In conclusion, a deeper S wave in lead V5 and the presence of a wider extent of negative T waves in the precordial leads may be clinically simple and useful ECG parameters for screening for PH.