Surface electrocardiogram detects signs of right ventricular pressure overload among acute-decompensated heart failure with preserved ejection fraction patients

Electrocardiographic characteristics in patients with heart failure and normal ejection fraction: A systematic review and meta‐analysis

“…The definition of HeFNEF varied among studies (Appendix II). In addition, different cutoffs for left ventricular ejection fraction (LVEF) were used to define HeFNEF: ≥40% (Cenkerova, Dubrava, Pokorna, Kaluzay, & Jurkovicova, ; Danciu et al, ; Hendry, Krisdinarti, & Erika, ), >40% (Hawkins et al, ; Olsson et al, ), ≥45% (Adabag et al, ; Donal et al, ; Joseph et al, ; Komajda et al, ; Nikolaidou et al, ; Shah et al, ), >45% (Ho et al, ; Lee et al, ; Park et al, ; Zile et al, ), ≥50% (Gigliotti et al, ; Gijsberts et al, ; Hummel, Skorcz, & Koelling, ; Khan et al, ; Lund et al, ; Martinez Santos et al, ; Masoudi et al, ; Menet et al, ; O'Neal et al, ; Pascual‐Figal et al, ; Peyster, Norman, & Domanski, ; Senni et al, ; Shenkman et al, ; Yap et al, ), >50% (Eicher et al, ; Oskouie, Prenner, Shah, & Sauer, ; Sanchis et al, ; Selvaraj et al, ; Shah et al, ), and ≥55% (Varadarajan & Pai, ). The following methods were used to measure ejection fraction: echocardiography, nuclear scintigraphy, and contrast ventriculography.…”

“…Left bundle branch block (LBBB) is present in up to 50% of patients with HeFREF(Danciu et al, ; Khan et al, ; Lund et al, ; Senni et al, ; Varadarajan & Pai, ) but only 0%–8% of patients with HeFNEF (Donal et al, ; Khan et al, ; Komajda et al, ; Lee et al, ; Masoudi et al, ; Menet et al, ; Peyster et al, ; Shah et al, ; Varadarajan & Pai, ). Right bundle branch block (RBBB) is present in 5%–11% of patients with HeFREF (weighted average 7%) (Donal et al, ; Khan et al, ; Lee et al, ; Shah et al, ; Varadarajan & Pai, ) and in 6%–16% (weighted average 9%) of patients with HeFNEF (Figure a) (Danciu et al, ; Donal et al, ; Hendry et al, ; Khan et al, ; Lee et al, ; Martinez Santos et al, ; Pascual‐Figal et al, ; Selvaraj et al, ; Varadarajan & Pai, ). RBBB is more common in patients with HeFNEF compared to HeFREF but without reaching statistical significance due to limited data available.…”

“…Right ventricular systolic dysfunction as a consequence of increased pulmonary artery pressure is common in HeFNEF. It is present in at least one‐fifth of patients with HeFNEF and is associated with worse prognosis (Gorter et al, ; Martinez Santos et al, ). Right heart failure is a common mode of death in patients with HeFNEF (Aschauer et al, ).…”