Electrocardiographic and hemodynamic correlations in primary pulmonary hypertension.
In order to evaluate the pulmonary hemodynamics in primary pulmonary hypertension, the relation between the standard 12-lead electrocardiogram (ECG) and pulmonary hemodynamics as determined by right-heart catheterization was analyzed. Significant positive correlations were noted between amplitude of the R in V1, the R/S ratio in V1, and the pulmonary artery systolic pressure (r = 0.46 and 0.50, respectively, p less than 0.01). An amplitude of the R in V1 of more than 1.2 mV indicated a pulmonary artery systolic pressure of more than 90 mmHg with a sensitivity of 94% and a specificity of 47%. The cardiac index showed a significant positive relationship with amplitude of the R in V5 and V6 and the R/S ratio in V5 and V6 (r = 0.46, 0.46, 0.39, and 0.48, respectively; each with a p less than 0.01). Moreover, an AQRS greater than or equal to 100 degrees, and either an SV6 greater than or equal to 0.7 mV, or R/SV6 less than or equal to 2 indicated a cardiac index of less than 2.8L/min/m2 with a sensitivity of 82% and 84% and a specificity of 86% and 100% respectively. This study suggests, therefore, that the 12-lead ECG is useful for the evaluation of the severity of pulmonary hypertension by its ability to predict pulmonary artery systolic pressure and cardiac index with clinically useful accuracy.
Department of Internal Medicine, School of Medicine, Tokai University, Kanagawa, Japan.
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Kanemoto
D000328:Adult; D001794:Blood Pressure; D006328:Cardiac Catheterization; D002302:Cardiac Output; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D011651:Pulmonary Artery / Q000502:physiology; D011652:Pulmonary Circulation