title: Surface electrocardiogram detects signs of right ventricular pressure overload among acute-decompensated heart failure with preserved ejection fraction patients.
abstract: Pulmonary hypertension (PH) is a common finding among patients with heart failure and preserved ejection fraction (HFpEF) and contributes to develop right ventricular systolic dysfunction (RVSD).
  
  
  
  We evaluated the diagnostic accuracy of Flowers and Horan electrocardiographic criteria to detect significant right ventricular pressure overload.
  
  
  
  123 patients were prospectively included. We used the Flowers and Horan (FH) ECG criteria to define RV enlargement (score >10). Echocardiographic measurements were performed blinded to the electrocardiographic results.
  
  
  
  Severe PH was found in 51.5%. Seventeen patients (16.5%) had a FH score >10 points. This was associated to RVSD (RR 2.66; 1.51-4.67 CI 95%, p=0.002), with 90.5% specificity and 34.4% sensitivity and to severe PH (RR 1.70; 1.16-2.50 CI 95%, p=0.028) with 91.9% specificity and 27.5% sensitivity.
  
  
  
  The ECG is a useful tool to classify HFpEF patients with echocardiographic signs of right ventricular pressure overload, in the absence of RBBB.
authors.affiliation: Hospital Universitario Fuenlabrada, Camino de Los Molinos 1, Fuenlabrada, Madrid, Spain. Electronic address: paulams1@hotmail.com.
authors.forename: Paula
authors.initials: P
authors.lastname: Martínez Santos
authors.affiliation: Hospital Universitario Clínico San Carlos, Profesor Martín Lagos s/n, Madrid, Spain.
authors.forename: Isidre
authors.initials: I
authors.lastname: Vilacosta
authors.affiliation: Hospital Universitario Fundación Alcorcón, Budapest 1, Alcorcón, Madrid, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Batlle López
authors.affiliation: Hospital Universitario Fundación Alcorcón, Budapest 1, Alcorcón, Madrid, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Sánchez Sauce
authors.affiliation: Hospital Universitario Fundación Alcorcón, Budapest 1, Alcorcón, Madrid, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: España Barrio
authors.affiliation: Hospital Universitario Fundación Alcorcón, Budapest 1, Alcorcón, Madrid, Spain.
authors.forename: Julia
authors.initials: J
authors.lastname: Jiménez Valtierra
authors.affiliation: Hospital Universitario Fundación Alcorcón, Budapest 1, Alcorcón, Madrid, Spain.
authors.forename: Adriana
authors.initials: A
authors.lastname: de la Rosa Riestra
authors.affiliation: Hospital Universitario Fundación Alcorcón, Budapest 1, Alcorcón, Madrid, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Campuzano Ruiz
mesh_terms: D000369:Aged, 80 and over; D000465:Algorithms; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000209:etiology; D017380:Hypertrophy, Right Ventricular / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013318:Stroke Volume; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000209:etiology
keywords: Flowers and Horan ECG criteria; Heart failure with preserved ejection fraction; pulmonary hypertension