A novel electrocardiographic index for the diagnosis of diastolic dysfunction
Mehdi Namdar1, Patric Biaggi, Barbara Stähli
1Heart Rhythm Management Centre, Cardiovascular Division, UZ Brussel - VUB, Brussels, Belgium ; Cardiovascular Centre, Cardiology, University Hospital of Zurich, Zurich, Switzerland ; Service de Cardiologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland.
Insights
A new electrocardiogram (ECG) index, Tend-P/(PQxAge), accurately identifies diastolic dysfunction (DD). Combining this ECG index with left atrial volume (LAESVI) further improves diagnostic accuracy for DD.
Area of Science:
- Cardiology
- Medical Diagnostics
- Biomedical Engineering
Background:
- Diastolic dysfunction (DD) assessment is crucial in cardiology.
- Limited understanding of associated electrocardiogram (ECG) changes in DD.
- Investigating ECG indices for improved DD recognition.
Purpose of the Study:
- To explore the role of ECG indices in identifying patients with diastolic dysfunction.
- To develop and validate a novel ECG-based index for DD diagnosis.
Main Methods:
- Retrospective assessment of ECG parameters in 172 individuals (83 controls, 89 DD patients).
- Validation of diagnostic performance in a separate group of 100 individuals (50 controls, 50 DD patients).
- Analysis of ECG parameters including QTc, Tend-P, Tend-Q, and PQ-interval.
Main Results:
- Patients with DD showed significantly longer QTc and PQ-intervals, and shorter Tend-P and Tend-Q intervals compared to controls.
- A novel index, Tend-P/(PQxAge), demonstrated high diagnostic performance for DD.
- Combining the Tend-P/(PQxAge) index with indexed left atrial volume (LAESVI) significantly enhanced diagnostic accuracy.
Conclusions:
- The novel ECG index Tend-P/(PQxAge) offers high diagnostic accuracy for DD.
- Integration of this ECG index with LAESVI provides substantial added diagnostic value for DD.
Background:
Although the assessment of diastolic dysfunction (DD) is an integral part of routine cardiologic examinations, little is known about associated electrocardiographic (ECG) changes. Our aim was to investigate a potential role of ECG indices for the recognition of patients with DD.
Methods And Results:
ECG parameters correlating with echocardiographic findings of DD were retrospectively assessed in a derivation group of 172 individuals (83 controls with normal diastolic function, 89 patients with DD) and their diagnostic performance was tested in a validation group of 50 controls and 50 patients. The patient group with a DD Grade 1 and 2 showed longer QTc (422 ± 24 ms and 434 ± 32 ms vs. 409 ± 25ms, p<0.0005) and shorter Tend-P and Tend-Q intervals, reflecting the electrical and mechanical diastole (240 ± 78 ms and 276 ± 108 ms vs. 373 ± 110 ms, p<0.0001; 409 ± 85 ms and 447 ± 115 ms vs. 526 ± 119 ms, p<0.0001). The PQ-interval was significantly longer in the patient group (169 ± 28ms and 171 ± 38ms vs. 153 ± 22ms, p<0.005). After adjusting for possible confounders, a novel index (Tend-P/[PQxAge]) showed a high performance for the recognition of DD, stayed robust in the validation group (sensitivity 82%, specificity 93%, positive predictive value 93%, negative predictive value 82%, accuracy 88%) and proved a substantial added value when combined with the indexed left atrial volume (LAESVI, sensitivity 90%, specificity 92%, positive predictive value 95%, negative predictive value 86%, accuracy 91%).
Conclusions:
A novel electrocardiographic index Tend-P/(PQxAge) demonstrates a high diagnostic accuracy for the diagnosis of DD and yields a substantial added value when combined with the LAESVI.
Related Concept Videos
01:29Electrocardiogram
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:30Dysrhythmias V: Evaluating Dysrhythmias
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies