title: Prediction of Pulmonary Arterial Hypertension in Chronic Obstructive Lung Disease from Three-Dimensional Vectorcardiographic Parameters.
abstract: OBJECTIVE
  The objective of our study was to assess diagnostic value of three-dimensional (3D) vectorcardiographic (VCG) parameters in detecting pulmonary arterial hypertension (PAH) in chronic obstructive lung disease (COLD) with and without right ventricular hypertrophy (RVH).
  
  
  METHODS
  The study group of 62 patients with COPD was stratified on the basis of color Doppler echocardiographic findings into three subgroups: non-PAH (n = 23), PAH without RVH (n = 22), and PAH with RVH (n = 17). Pairwise differences between the subgroups were evaluated by one-way analysis of variance, and Pearson correlation analysis was used to evaluate the significance of the correlations between pulmonary arterial systolic pressure (PASP) and various VCG parameters.
  
  
  RESULTS
  The azimuth of the QRS vector decreased from -24° in the non-PAH group to -62° in PAH without RVH and to -140° in PAH with RVH (P < 0.01 for pairwise differences between all three groups). Similar significant decrease was observed for the azimuth of the ventricular gradient (VG) vector. Spatial QRS/T angle increased from 69° in the non-PAH group to 115° in PAH without RVH (P < 0.01). In the PAH group with RVH, QRS/T angle was 94° (P < 0.05 for difference from the non-PAH group). There was a significant correlation between PASP and QRS/T angle (r = 0.89, P < 0.05) and between PASP and the azimuth of the VG vector (r = 0.86, P < 0.05). PASP increase from linear regression model was 0.8 mmHg for a QRS/T angle increase by 10° and 1.3 mmHg for each 10° increase in the azimuth of the VG vector.
  
  
  CONCLUSIONS
  3DVCG parameters are potentially useful for predicting PASP in COLD patients, and possibly also for differentiation between COLD patients with PAH and RVH from those without RVH.
authors.affiliation: Department of Respiration Medicine of the First Affiliated Hospital of Liaoning Medical University, Jinzhou, Liaoning Province, China.
authors.forename: Dianzhu
authors.initials: D
authors.lastname: Pan
authors.affiliation: The Cardiovascular Institute of the First Affiliated Hospital of Liaoning Medical University, Jinzhou, Liaoning Province, China.
authors.forename: Renguang
authors.initials: R
authors.lastname: Liu
authors.affiliation: The Cardiovascular Institute of the First Affiliated Hospital of Liaoning Medical University, Jinzhou, Liaoning Province, China.
authors.forename: Shuzhen
authors.initials: S
authors.lastname: Ren
authors.affiliation: Department of Respiration Medicine of the First Affiliated Hospital of Liaoning Medical University, Jinzhou, Liaoning Province, China.
authors.forename: Changjun
authors.initials: C
authors.lastname: Li
authors.affiliation: The Cardiovascular Institute of the First Affiliated Hospital of Liaoning Medical University, Jinzhou, Liaoning Province, China.
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Chang
mesh_terms: D000368:Aged; D018618:Echocardiography, Doppler, Color; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology*; D008297:Male; D011237:Predictive Value of Tests; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D014672:Vectorcardiography / Q000379:methods*
keywords: electrocardiography; pulmonary arterial hypertension; pulmonary chronic obstructive; vectorcardiography