ECG Markers of Hemodynamic Improvement in Patients with Pulmonary Hypertension

Waligóra, Marcin; Tyrka, Anna; Podolec, Piotr; Kopeć, Grzegorz

doi:10.1155/2018/4606053

Cited by 16 publications

(25 citation statements)

References 39 publications

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“…Several previous studies, for example, by Waligóra et al and Cheng et al, demonstrated the importance of the P‐wave amplitude, when compared to the other ECG parameters, in revealing hemodynamic improvement in patients with PAH, following the application of targeted pharmacotherapy (Cheng et al, 2017; Waligora, Tyrka, Podolec, & Kopec, 2018). The study by Cheng et al showed a significant correlation between the P‐wave amplitude and the mPAP value ( r = .35, p < .001), and between the P‐wave amplitude and CI ( r = −.22, p = .002).…”

Section: Discussionmentioning

confidence: 99%

Assessment of electrocardiographic markers of acute and long‐term hemodynamic improvement in patients with pulmonary hypertension

Piłka¹,

Darocha²,

Banaszkiewicz³

et al. 2020

Noninvasive Electrocardiol

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Background The remodeling of the right heart in patients with chronic pulmonary hypertension (cPH) is associated with the appearance of electrocardiographic (ECG) abnormalities. We investigated the resolution of ECG markers of right ventricular hypertrophy (RVH) caused by acute and long‐term hemodynamic improvement. Methods Twenty‐nine (29) patients with chronic thromboembolic pulmonary hypertension (CTEPH) and seven patients with pulmonary arterial hypertension (PAH) were included in the analysis. Patients with CTEPH achieved a significant long‐term hemodynamic improvement following the treatment with balloon pulmonary angioplasty (BPA); all the patients with PAH reported significant acute hemodynamic relief after a single inhalation of iloprost, fulfilling the criteria of responder. Standard 12‐lead ECG was performed before and after intervention. Results The interval between baseline and control ECG in CTEPH and PAH groups was 28 (IQR: 17–36) months and 15 min (IQR: 11–17), respectively. Despite similar hemodynamic improvement in both groups, only the CTEPH group presented significant changes in most analyzed ECG parameters: T‐wave axis (p = .002), QRS‐wave axis (p = .012), P‐wave amplitude (p < .001) and duration in II (p = .049), R‐wave amplitude in V1 (p = .017), R:S ratio in V1 (p = .046), S‐wave amplitude in V5 (p = .004), R‐wave amplitude in V5 (p = .044), R:S ratio in V5 (p = .004), S‐wave amplitude in V6 (p = .026), R‐wave amplitude in V6 (p = .01), and R‐wave amplitude in aVR (p = .031). In patients with PAH, significant differences were found only for P wave in II (duration: p = .035; amplitude: p = .043) and QRS axis (p = .018). Conclusions The effective treatment of cPH ensures improvement in ECG parameters of RVH, but it requires extended time.

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Section: Discussionmentioning

confidence: 99%

Assessment of electrocardiographic markers of acute and long‐term hemodynamic improvement in patients with pulmonary hypertension

Piłka¹,

Darocha²,

Banaszkiewicz³

et al. 2020

Noninvasive Electrocardiol

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“…In adults with PAH, increased P wave amplitude in lead II, the presence of a qR-pattern or increased R wave amplitude in lead V1 are associated with worse hemodynamics and decreased survival (45,46). Treatment-induced changes of ECG parameters reflecting RV hypertrophy are associated with concurrent changes in hemodynamics and survival (47)(48)(49), providing clues that ECG biomarkers can serve as adjunct prognosticators for risk stratification and for monitoring the disease over time.…”

Section: Electrocardiographic Biomarkersmentioning

confidence: 99%

Prognostic biomarkers in pediatric pulmonary arterial hypertension

Ploegstra¹,

Berger²

2021

Cardiovasc Diagn Ther

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Pulmonary arterial hypertension (PAH) is a progressive life-threatening disease of the pulmonary vasculature. Despite the introduction of targeted therapies, prognosis remains poor. In pediatric PAH, reliable prognostic biomarkers are needed to inform clinicians on disease progression and risk of mortality, in order to be able to assess the need for escalation of medical therapy, consider surgical options such as Pott's shunt and listing for (heart)-lung transplantation. This review provides an overview of prognostic biomarkers that are considered to carry potential for the clinical management of pediatric PAH. These include conventional physiological biomarkers [resting heart rate, heart rate variability (HRV), a child's growth], biomarkers of functional status [World Health Organization functional class, 6-minute walk distance (6MWD), parameters derived from cardiopulmonary exercise testing (CPET), daily physical activity level], electrocardiographic biomarkers, circulating serum biomarkers (natriuretic peptides, uric acid, neurohormones, inflammatory markers, and novel circulating biomarkers), and multiple hemodynamic biomarkers and imaging biomarkers [echocardiography and cardiac magnetic resonance (CMR)]. In recent years, many potential prognostic biomarkers have become available for the management of PAH in children. As the available prognostic biomarkers reflect different aspects of the disease process and functional implications, a multi-marker approach appears the most useful for guiding therapy decisions and improve outcome in pediatric PAH.

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“…In addition, ST segment depression [ 25 ] and higher QRS amplitude also exhibited the information of hypertension [ 26 ]. Meanwhile, the ECG can be potentially used for pulmonary hypertension evaluation [ 27 , 28 ]. Recently, a single ECG signal has been utilized to investigate the hypertension system [ 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

Non-Invasive Hemodynamics Monitoring System Based on Electrocardiography via Deep Convolutional Autoencoder

Sadrawi

Lin²,

Lin³

et al. 2021

Sensors

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This study evaluates cardiovascular and cerebral hemodynamics systems by only using non-invasive electrocardiography (ECG) signals. The Massachusetts General Hospital/Marquette Foundation (MGH/MF) and Cerebral Hemodynamic Autoregulatory Information System Database (CHARIS DB) from the PhysioNet database are used for cardiovascular and cerebral hemodynamics, respectively. For cardiovascular hemodynamics, the ECG is used for generating the arterial blood pressure (ABP), central venous pressure (CVP), and pulmonary arterial pressure (PAP). Meanwhile, for cerebral hemodynamics, the ECG is utilized for the intracranial pressure (ICP) generator. A deep convolutional autoencoder system is applied for this study. The cross-validation method with Pearson’s linear correlation (R), root mean squared error (RMSE), and mean absolute error (MAE) are measured for the evaluations. Initially, the ECG is used to generate the cardiovascular waveform. For the ABP system—the systolic blood pressure (SBP) and diastolic blood pressures (DBP)—the R evaluations are 0.894 ± 0.004 and 0.881 ± 0.005, respectively. The MAE evaluations for SBP and DBP are, respectively, 6.645 ± 0.353 mmHg and 3.210 ± 0.104 mmHg. Furthermore, for the PAP system—the systolic and diastolic pressures—the R evaluations are 0.864 ± 0.003 mmHg and 0.817 ± 0.006 mmHg, respectively. The MAE evaluations for systolic and diastolic pressures are, respectively, 3.847 ± 0.136 mmHg and 2.964 ± 0.181 mmHg. Meanwhile, the mean CVP evaluations are 0.916 ± 0.001, 2.220 ± 0.039 mmHg, and 1.329 ± 0.036 mmHg, respectively, for R, RMSE, and MAE. For the mean ICP evaluation in cerebral hemodynamics, the R and MAE evaluations are 0.914 ± 0.003 and 2.404 ± 0.043 mmHg, respectively. This study, as a proof of concept, concludes that the non-invasive cardiovascular and cerebral hemodynamics systems can be potentially investigated by only using the ECG signal.

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ECG Markers of Hemodynamic Improvement in Patients with Pulmonary Hypertension

Cited by 16 publications

References 39 publications

Assessment of electrocardiographic markers of acute and long‐term hemodynamic improvement in patients with pulmonary hypertension

Assessment of electrocardiographic markers of acute and long‐term hemodynamic improvement in patients with pulmonary hypertension

Prognostic biomarkers in pediatric pulmonary arterial hypertension

Non-Invasive Hemodynamics Monitoring System Based on Electrocardiography via Deep Convolutional Autoencoder

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