Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
ORIGINAL ARTICLES
Significance of Electrocardiographic Right Ventricular Hypertrophy in Patients with Pulmonary Hypertension with or without Right Ventricular Systolic Dysfunction
Toshiyuki NagaiShun KohsakaMitsushige MurataShigeo OkudaToshihisa AnzaiKeiichi FukudaToru Satoh
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JOURNAL OPEN ACCESS

2012 Volume 51 Issue 17 Pages 2277-2283

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Abstract

Objective We sought to determine the value of electrocardiographic right ventricular hypertrophy (ECG-RVH) in pulmonary hypertension (PH) patients with right ventricular systolic dysfunction defined by cardiac magnetic resonance (CMR-RVSD).
Patients A total of 31 consecutive patients with PH with a mean pulmonary arterial pressure of >25 mmHg underwent both ECG and CMR studies. Patients were divided into 2 groups according to the presence of RVSD, defined as a RV ejection fraction <35%. Logistic regression modeling was performed to define the association between ECG-RVH and CMR-RVSD.
Results About half of the patients had RVSD (n=15 ; 48%). The R to S wave ratio (p=0.01) or incidence of qR pattern (p=0.002) in lead V1 was significantly greater in patients with PH complicated by RVSD than in those without RVSD. These 2 patterns were significant predictors of RVSD [odds ratio (OR), 19.3 for qR; OR, 14.0 for R/S>1] and when each of these ECG findings was assigned with a point proportional to OR (score of 2 for qR in lead V1 and score of 1 for R/S>1 in lead V1), the incidence of RVSD increased by the total ECG score.
Conclusion The combination of ECG-RVH findings, especially in lead V1, predicts the presence of RVSD defined by CMR. ECG might be a useful tool for estimating the presence of RVSD in patients with PH.

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© 2012 by The Japanese Society of Internal Medicine
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