A simple formula to predict echocardiographic diastolic dysfunction-electrocardiographic diastolic index
Mert İlker Hayıroğlu1, Tufan Çınar2, Vedat Çiçek2
1Department of Cardiology, Haydarpasa Sultan Abdulhamid Han Training and Research Hospital, 34668, Kadikoy-Istanbul, Turkey. mertilkerh@yahoo.com.
Insights
A new electrocardiographic diastolic index (EDI) can predict diastolic dysfunction (DD) in adults. This simple ECG tool offers high accuracy, aiding cardiologists in diagnosing DD non-invasively.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Electrocardiography
Background:
- Diastolic dysfunction (DD) is a common but poorly understood cardiac condition.
- Current diagnostic methods like transthoracic echocardiography (TTE) have limitations.
- An electrocardiogram (ECG)-based index for predicting DD is needed.
Purpose of the Study:
- To develop and validate an electrocardiographic diastolic index (EDI) for predicting TTE-diagnosed DD.
- To assess the sensitivity and specificity of the EDI in identifying DD.
- To establish the clinical utility of a novel ECG-based marker for diastolic function.
Main Methods:
- A retrospective analysis of 204 adult patients without coronary artery disease was performed.
- The electrocardiographic diastolic index (EDI) formula was applied to patient ECG data.
- Receiver operating curve (ROC) analysis was used to determine the predictive value of EDI and its components.
Main Results:
- The EDI demonstrated a significant association with DD, with higher tertiles showing increased risk (OR 25.2).
- Spearman correlation indicated a moderate relationship between EDI and E/e' ratio.
- ROC analysis identified an optimal EDI cut-off of 8.53 mV, yielding 70% sensitivity and 70% specificity for DD prediction (AUC 0.78).
Conclusions:
- The electrocardiographic diastolic index (EDI) is a promising, inexpensive, and easily applicable tool.
- EDI shows considerable potential for predicting diastolic dysfunction in adult patients.
- This ECG-based index may enhance non-invasive assessment of diastolic function in clinical cardiology.
Background:
Diastolic dysfunction (DD) in transthoracic echocardiography (TTE), which is a poorly understood entity due to its limited treatment, is frequently encountered in daily clinical practice of cardiology. An electrocardiographic (ECG) index to predict echocardiographic DD has not been elucidated yet. We aim to exhibit an electrocardiographic diastolic index (EDI) to predict TTE DD with high sensitivity and specificity.
Materials And Methods:
In this retrospective investigation, we tested the DD predictive value of EDI [aVL R amplitude × (V1S amplitude + V5R amplitude)/D1 P amplitude] on 204 consecutive adult patients without known coronary artery disease. Patients were divided into tertiles according to their EDI starting from the lowest one. The power of the EDI was also compared with the subunits of its formula by a receiver operating curve (ROC) analysis.
Results:
After adjustment for confounding baseline variables, EDI in tertile 3 was associated with 24.2-fold hazard ratio of DD (odds ratio 25.2, 95% confidence interval [CI] 11.2-51.1, p < 0.001). The Spearman correlation analysis revealed moderate correlation between E/e' and EDI. A ROC analysis showed that the optimal cut-off value of the EDI to predict DD was 8.53 mV with 70% sensitivity and 70% specificity (area under the curve 0.78; 95% CI 0.71-0.84; p < 0.001).
Conclusion:
The electrocardiographic diastolic index (EDI), which is an inexpensive, feasible, and easy to use formula, appears to have a considerable role to predict diastolic dysfunction (DD) in adult patients.
