A Novel Electrocardiographic Index for the Diagnosis of Diastolic Dysfunction

PLoS One

Pedro Brugada¹  Christian Schmied¹  Danilo Ricciardi¹  Rubén Casado-Arroyo¹  Firat Duru¹  Carlo de Asmundis¹  Gian-Battista Chierchia¹  Walter J. Paulus¹  Bernhard Bütler¹  Patric Biaggi¹  Mehdi Namdar²  David Hürlimann²  Rolf Jenni²  Jan Steffel²  Moisés Rodríguez-Mañero²  Andrea Sarkozy²  Thomas F. Lüscher²  Barbara Stähli³ 

[1] Cardiovascular Centre, Cardiology, University Hospital of Zurich, Zurich, Switzerland;Heart Rhythm Management Centre, Cardiovascular Division, UZ Brussel — VUB, Brussels, Belgium;Service de Cardiologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland

关键词: Electrocardiography;    Heart rate;    Diastole;    Heart failure;    Cardiac hypertrophy;    Atrial fibrillation;    Diagnostic medicine;    Patients;   

DOI  :  10.1371/journal.pone.0079152

学科分类：医学（综合）

来源: Public Library of Science

【 摘 要 】

BackgroundAlthough the assessment of diastolic dysfunction (DD) is an integral part of routine cardiologic examinations, little is known about associated electrocardiographic (ECG) changes. Our aim was to investigate a potential role of ECG indices for the recognition of patients with DD. Methods and ResultsECG parameters correlating with echocardiographic findings of DD were retrospectively assessed in a derivation group of 172 individuals (83 controls with normal diastolic function, 89 patients with DD) and their diagnostic performance was tested in a validation group of 50 controls and 50 patients. The patient group with a DD Grade 1 and 2 showed longer QTc (422±24ms and 434±32ms vs. 409±25ms, p<0.0005) and shorter Tend–P and Tend–Q intervals, reflecting the electrical and mechanical diastole (240±78ms and 276±108ms vs. 373±110ms, p<0.0001; 409±85ms and 447±115ms vs. 526±119ms, p<0.0001). The PQ–interval was significantly longer in the patient group (169±28ms and 171±38ms vs. 153±22ms, p<0.005). After adjusting for possible confounders, a novel index (Tend–P/[PQxAge]) showed a high performance for the recognition of DD, stayed robust in the validation group (sensitivity 82%, specificity 93%, positive predictive value 93%, negative predictive value 82%, accuracy 88%) and proved a substantial added value when combined with the indexed left atrial volume (LAESVI, sensitivity 90%, specificity 92%, positive predictive value 95%, negative predictive value 86%, accuracy 91%). ConclusionsA novel electrocardiographic index Tend–P/(PQxAge) demonstrates a high diagnostic accuracy for the diagnosis of DD and yields a substantial added value when combined with the LAESVI.

【 授权许可】

CC BY