Value of the Electrocardiogram as a Predictor of Right Ventricular Dysfunction in Patients With Chronic Right Ventricular Volume Overload.

Data de publicació: 01/05/2015

Autors de IIS La Fe

Grups d'Investigació

Dermatología y Regeneración Tisular

Leader

Rafael Botella Estrada
Grupo de Investigación Clínica y Traslacional en Cardiología

Investigador Principal

Esther Roselló Lletí
Hemostasia, Trombosis, Arteriosclerosis y Biología vascular

Investigador Principal

Pilar Medina Badenes
Regeneración y Trasplante Cardíaco

Leader

Pilar Sepúlveda Sanchis

Abstract

INTRODUCTION AND OBJECTIVES: Pulmonary regurgitation is a common complication in patients with repaired tetralogy of Fallot or congenital pulmonary stenosis. Electrocardiographic variables have been correlated with parameters used to evaluate right ventricular function. We aimed to analyze the diagnostic value of the width and fragmentation of the electrocardiogram in the identification of patients with right ventricular dysfunction and/or dilation. METHODS: We selected 107 consecutive patients diagnosed with severe pulmonary insufficiency after repair of pulmonary stenosis or tetralogy of Fallot. The tests included electrocardiography, echocardiography, and magnetic resonance. Each electrocardiogram was analyzed manually to measure QRS duration. We defined QRS fragmentation as the presence of low-voltage waves in the terminal portion of the QRS complex in at least 2 contiguous leads. RESULTS: We found a significant negative correlation between QRS width and right ventricular function, as well as a positive correlation with right ventricular volume. The receiver operating characteristic curve indicated a cut-off point for QRS width of 140ms, which showed good sensitivity for a diagnosis of right ventricular dilation (> 80%) and dysfunction (> 95%). In logistic regression models, a QRS duration > 140ms was found to be the only independent predictor of right ventricular dilation and dysfunction. CONCLUSIONS: Electrocardiography is a rapid, widely available, and reproducible tool. QRS width constitutes an independent predictor of the presence of right ventricular dilation and dysfunction. This study is the first to provide a cutoff value for QRS width to screen for right ventricle involvement.

Dades de la publicació

ISSN/ISSNe:: 1885-5857, 1885-5857
Tipus:: Article
Pàgines:: 390-397
DOI:: 10.1016/j.rec.2014.04.019
PubMed:: 25304084
Factor d'Impacte:: 0,141 SCImago ℠
Quartil:: Q4 SCImago ℠

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Mètriques

Filiacions

Alonso P:: Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Andrés A:: Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Rueda J:: Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Buendía F:: Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Igual B:: ERESA, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Rodríguez M:: Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Osa A:: Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Arnau MA:: Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Salvador A:: Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain

Keywords

Fragmentacion; Fragmentation; Insuficiencia pulmonar; Pulmonary regurgitation; QRS; Tetralogy of Fallot; Tetralogia de Fallot

Projectes associats

RED INVESTIGACION (RECAVA)

RD06/0014/0004 . INSTITUTO DE SALUD CARLOS III; FUNDACION PARA LA INV BIOMEDICA- HOSPITAL GREGORIO MARAÑON; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2006