Electrocardiographic recognition of right ventricular hypertrophy

Nikus, Kjell; Pérez‐Riera, Andrés Ricardo; Konttila, Kaari K; Barbosa‐Barros, Raimundo

doi:10.1016/j.jelectrocard.2017.09.004

Cited by 12 publications

(8 citation statements)

References 8 publications

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“…The dynamic changes of ECG in this case suggested that the ECG characteristics could be useful in facilitating early diagnosis of compressed PAS by mediastinum metastasis in patients with lung cancer at follow-ups, although there are some studies that showed that some of these features indicated PE and CAD . These ECG features may be associated with right ventricular enlargement (right axis deviation, right bundle branch block, deepened S wave in lead I, substantial R wave in lead aVR) and endomyocardial ischemia of the right ventricle (inverted/flattened T waves in limb and precordial leads), both of which are caused by pressure overload of the right ventricle generated by chronic PAS . Overall, this article highlights the importance of regular ECG in patients with malignant neoplasms in the lung or mediastinum.…”

Section: Discussionmentioning

confidence: 83%

“…4,5 These ECG features may be associated with right ventricular enlargement (right axis deviation, right bundle branch block, deepened S wave in lead I, substantial R wave in lead aVR) and endomyocardial ischemia of the right ventricle (inverted/flattened T waves in limb and precordial leads), both of which are caused by pressure overload of the right ventricle generated by chronic PAS. 6 Overall, this article highlights the importance of regular ECG in patients with malignant neoplasms in the lung or mediastinum. Chronic PAS, acute PE, and CAD could share some similar ECG features with each other.…”

Section: Discussionmentioning

confidence: 89%

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Electrocardiogram Alarm for Mediastinum Metastasis in a Patient With Lung Cancer

Zhang

Cao

2021

JAMA Intern Med

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 89%

Electrocardiogram Alarm for Mediastinum Metastasis in a Patient With Lung Cancer

Zhang

Cao

2021

JAMA Intern Med

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“…A considerable degree of RVH needs to be present to overcome these left ventricular vectors. Because of this, most ECG criteria for RVH have low sensitivity and specificity 10 23 24. Increased RV mass causes a rightward deviated ventricular axis.…”

Section: Discussionmentioning

confidence: 99%

Role of the electrocardiogram in the risk stratification of pulmonary hypertension

Hendriks

Kauling

Geenen

et al. 2022

Heart

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IntroductionThe prognosis of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) remains dismal. Better risk prediction is needed. This study investigated the prognostic value of ECG characteristics.MethodsIn this single-centre prospective study, consecutive treatment-naïve patients with PAH or CTEPH were included at time of diagnosis. From the 12-lead ECG, obtained at baseline, the following parameters were collected: heart rate (HR), rhythm, QRS axis, conduction times, P-top amplitudes in II, R-top and S-wave amplitudes in V1 and V5 and repolarisation disorders. Associations between the ECG and transplant-free survival was assessed by Kaplan-Meier curves and Cox-proportional hazard regressions.ResultsIn total, 140 patients were included (median age: 60.7 years, 63.6% female). The ECG was abnormal in 86.2%: sinus rhythm was not present in 9.3%, right QRS axis was observed in 47.8%, mean QRS duration was 101±17 ms. Only 42.5% of the patients had normal repolarisation, 34.5% had right ventricular strain and 14.4% non-specific repolarisation disorders. Over a median follow-up time of 3.49 (IQR: 1.37–6.42) years, 45 patients (32.5%) died or underwent lung transplantation. Transplant-free survival was worse in patients presenting with an abnormal ECG (64.0% vs 86.0%; p=0.037). The following ECG characteristics were associated with all-cause mortality or lung transplantation: heart rate (HR 1.02, 95% CI: 1.00 to 1.05), QRS duration >120 ms (HR 2.61, 95% CI: 1.01 to 6.71) and S-wave amplitude in V5 (HR 1.10, 95% CI: 1.04 to 1.17).ConclusionOnly 13.8% of patients with PAH and CTEPH presented with a normal ECG, which is associated with favourable outcome. The ECG provides additional prognostic value to current clinical parameters and should be considered in risk prediction.

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“…Kors regression transformation has advantages over Frank’s orthogonal lead system. It is much easier to identify myocardial infarction [41,42,43,44,45,46], hypertrophy [47,48,49], and ischaemic heart disease [50,51] from the VCG compared to the ECG. However it is important to properly estimate the VCG from the ECG.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Different Electrocardiography with Vectorcardiography Transformations

Jaroš

Martínek

Danys

2019

Sensors

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This paper deals with transformations from electrocardiographic (ECG) to vectorcardiographic (VCG) leads. VCG provides better sensitivity, for example for the detection of myocardial infarction, ischemia, and hypertrophy. However, in clinical practice, measurement of VCG is not usually used because it requires additional electrodes placed on the patient’s body. Instead, mathematical transformations are used for deriving VCG from 12-leads ECG. In this work, Kors quasi-orthogonal transformation, inverse Dower transformation, Kors regression transformation, and linear regression-based transformations for deriving P wave (PLSV) and QRS complex (QLSV) are implemented and compared. These transformation methods were not yet compared before, so we have selected them for this paper. Transformation methods were compared for the data from the Physikalisch-Technische Bundesanstalt (PTB) database and their accuracy was evaluated using a mean squared error (MSE) and a correlation coefficient (R) between the derived and directly measured Frank’s leads. Based on the statistical analysis, Kors regression transformation was significantly more accurate for the derivation of the X and Y leads than the others. For the Z lead, there were no statistically significant differences in the medians between Kors regression transformation and the PLSV and QLSV methods. This paper thoroughly compared multiple VCG transformation methods to conventional VCG Frank’s orthogonal lead system, used in clinical practice.

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Electrocardiographic recognition of right ventricular hypertrophy

Cited by 12 publications

References 8 publications

Electrocardiogram Alarm for Mediastinum Metastasis in a Patient With Lung Cancer

Electrocardiogram Alarm for Mediastinum Metastasis in a Patient With Lung Cancer

Role of the electrocardiogram in the risk stratification of pulmonary hypertension

Comparison of Different Electrocardiography with Vectorcardiography Transformations

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