title: Increase in QRS amplitudes is better than N-terminal pro-B-type natriuretic peptide to predict clinical improvement in decompensated heart failure.
abstract: BACKGROUND
  We aimed to investigate the correlation between ECG QRS voltage changes, N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and clinical improvement in decompensated heart failure (DHF).
  
  
  RESULTS
  DHF patients (n=56) with a mean age of 67.5±12.6 years showed limb QRS amplitude increase and NT-proBNP level decrease with clinical improvement (p<0.001). Significant correlation was found between percent changes (Δ%) in body weight and Δ% in QRS voltages of aVR, aVF, DII, ΣQRSI+II and ΣQRS (all limb-leads) (r = -0.40; r = -0.35; r = -0.32; r = -0.30; r = -0.30 respectively, p<0.05). No correlation was found between Δ% in NT-proBNP and body weight (r = -0.23, p=0.09). Δ% NT-proBNP was correlated with Δ% QRS voltage only in aVR (r = -0.312, p=0.019). In ROC analysis, ≥0.5 mm increase in aVR QRS voltage was found to predict ≥5 kg weight loss with a sensitivity of 74% and specificity of 62% (p=0.013, AUC: 0.699).
  
  
  CONCLUSIONS
  Increase in QRS voltages especially in aVR was found to be more sensitive than NT-proBNP to predict clinical improvement in DHF.
authors.affiliation: Department of Cardiology, School of Medicine, Marmara University, Istanbul, Turkey.
authors.forename: Erdal
authors.initials: E
authors.lastname: Durmus
authors.affiliation: Department of Cardiology, School of Medicine, Marmara University, Istanbul, Turkey. Electronic address: burakhunuk@hotmail.com.
authors.forename: Burak
authors.initials: B
authors.lastname: Hunuk
authors.affiliation: Department of Cardiology, School of Medicine, Marmara University, Istanbul, Turkey.
authors.forename: Okan
authors.initials: O
authors.lastname: Erdogan
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Body weight; ECG; Heart failure; NT-proBNP; QRS voltage; aVR