Electrocardiogram-based scoring system for predicting secondary pulmonary hypertension: A cross-sectional study.
OBJECTIVE
In this study, we have developed an electrocardiogram-based scoring system to predict secondary pulmonary hypertension.


METHODS
A cross-sectional study.


METHODS
Single tertiary-care hospital in Scranton, Pennsylvania, USA.


METHODS
Five hundred and fifty-two consecutive patients undergoing right heart catheterization between 2006 and 2009.


METHODS
Surface electrocardiogram was assessed for R-wave in lead V1 ≥ 6mm, R-wave in V6 ≤ 3mm, S-wave in V6 ≥ 3mm, right atrial enlargement, right axis deviation and left atrial enlargement. Pulmonary hypertension was defined as mean pulmonary artery pressure ≥25 mmHg, determined by right heart catheterization.


RESULTS
A total of 297 (54%) patients in the study cohort had pulmonary hypertension. In total, 332 patients from the study cohort formed the development cohort and the remaining 220 patients formed the validation cohort. In the development cohort, based on log odds ratios of association, RAE, LAE, RAD, R-wave in V1 ≥ 6 mm were assigned scores of 5, 2, 2 and 1, respectively, to form a 10-point scoring system "Scranton PHT (SP) score". SP scores of 5 points and 7 points in DC showed C-statistic of 0.83 and 0.89, respectively, for discriminating pulmonary hypertension. C-statistic for RAE alone was significantly lower compared to an SP score of 7 (0.83 vs. 0.89, P = 0.021). The reliability of SP score in the validation cohort was acceptable.


CONCLUSIONS
SP score provides a good point-of-care tool to predict pulmonary hypertension in patients with clinical suspicion of it.
The Wright Center for Graduate Medical Education, USA.
Samir Bipin
SB
Pancholy
The Wright Center for Graduate Medical Education, USA.
Ghanshyam
G
Palamaner Subash Shantha
The Wright Center for Graduate Medical Education, USA.
Nimesh Kirit
NK
Patel
The Wright Center for Graduate Medical Education, USA.
Pranjal
P
Boruah
The Wright Center for Graduate Medical Education, USA.
Sukrut
S
Nanavaty
The Wright Center for Graduate Medical Education, USA.
Sindu
S
Chandran
The Wright Center for Graduate Medical Education, USA.
Arjinder
A
Sethi
The Wright Center for Graduate Medical Education, USA.
Jignesh
J
Sheth
Pulmonary hypertension; electrocardiography; scoring method