Detection of Elevated Pulmonary Pressures by the ECG-derived Ventricular Gradient: a Comparison of Conversion Matrices in Patients with Suspected Pulmonary Hypertension

• Published in: Journal of electrocardiology 2017-01, Vol.50 (1), p.115-122
• Main Authors: Haeck, Marlieke L.A., MD, Kapel, Gijsbert F.L., MD, Scherptong, Roderick W.C., MD, PhD, Swenne, Cees A., PhD, Maan, Arie C., PhD, Bax, Jeroen J., MD, PhD, Schalij, Martin J., MD, PhD, Vliegen, Hubert W., MD, PhD
• Format: Article
• Language: English
• Subjects: Algorithms; Blood Pressure Determination - methods; Cardiac arrhythmia; Cardiovascular; Diagnosis, Computer-Assisted - methods; Electrocardiogram; Electrocardiography; Electrocardiography - methods; Female; Humans; Hypertension, Pulmonary - diagnosis; Male; Middle Aged; Pulmonary hypertension; Reproducibility of Results; Sensitivity and Specificity; Vectorcardiography - methods; Ventricular gradient
• ISSN: 0022-0736; 1532-8430
• DOI: 10.1016/j.jelectrocard.2016.09.002

Abstract Background The aim was to assess the diagnostic value of the Inverse Dower (INVD)-derived vectorcardiogram (VCG) and the Kors-derived VCG to detect elevated systolic pulmonary artery pressure (SPAP) in suspected pulmonary hypertension (PH). Methods In 132 patients, morphologic variables were evaluated by comparing the VCG parameters synthesized by INVD and Kors matrix. Comparison of the diagnostic accuracy of detecting SPAP≥50 mmHg between the matrices was performed by ROC curve analysis and logistic regression analysis. Results Most VCG parameters differed significantly between INVD and Kors. ROC analysis for detection of SPAP≥50 mmHg by VG projected on the X-axis demonstrated no difference (p=0.99) between INVD (AUC=0.80) and Kors (AUC=0.80). Both the INVD- and Kors-derived VCG provided significant diagnostic information on the presence of SPAP≥50 mmHg (INVD, OR 1.05, 95%CI 1.03–1.07; P