Electrocardiogram-based scoring system for predicting secondary pulmonary hypertension: A cross-sectional study

Area of Science:

• Cardiology
• Pulmonary Medicine
• Medical Diagnostics

Background:

• Pulmonary hypertension (PH) is a serious condition requiring accurate prediction.
• Current diagnostic methods can be invasive or delayed.

Purpose of the Study:

• To develop and validate an electrocardiogram (ECG)-based scoring system to predict secondary pulmonary hypertension.
• To establish a simple, non-invasive tool for early PH detection.

Main Methods:

• A cross-sectional study involving 552 patients undergoing right heart catheterization.
• ECG parameters including R-wave in V1, R-wave in V6, S-wave in V6, right atrial enlargement (RAE), right axis deviation (RAD), and left atrial enlargement (LAE) were assessed.
• A 10-point scoring system, the Scranton PHT (SP) score, was developed and validated.

Main Results:

• 54% of patients had pulmonary hypertension (mean pulmonary artery pressure ≥25 mmHg).
• The SP score demonstrated good discriminatory ability for PH in both development (C-statistic 0.83-0.89) and validation cohorts.
• The SP score showed superior predictive value compared to individual ECG findings like RAE.

Conclusions:

• The Scranton PHT (SP) score is a reliable, point-of-care tool for predicting pulmonary hypertension.
• This ECG-based system can aid clinicians in identifying patients who require further investigation for PH.