A Novel Electrocardiographic Index for the Diagnosis of Diastolic Dysfunction |
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Authors: | Mehdi Namdar Patric Biaggi Barbara St?hli Bernhard Bütler Rubén Casado-Arroyo Danilo Ricciardi Moisés Rodríguez-Ma?ero Jan Steffel David Hürlimann Christian Schmied Carlo de Asmundis Gian-Battista Chierchia Andrea Sarkozy Thomas F Lüscher Rolf Jenni Firat Duru Walter J Paulus Pedro Brugada |
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Institution: | 1. Heart Rhythm Management Centre, Cardiovascular Division, UZ Brussel — VUB, Brussels, Belgium.; 2. Cardiovascular Centre, Cardiology, University Hospital of Zurich, Zurich, Switzerland.; 3. Department of Physiology, VU University Medical Center, Amsterdam, The Netherlands.; 4. Service de Cardiologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland.; University of Cologne, Germany, |
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Abstract: | BackgroundAlthough the assessment of diastolic dysfunction (DD) is an integral part of routine cardiologic examinations, little is known about associated electrocardiographic (ECG) changes. Our aim was to investigate a potential role of ECG indices for the recognition of patients with DD.Methods and ResultsECG parameters correlating with echocardiographic findings of DD were retrospectively assessed in a derivation group of 172 individuals (83 controls with normal diastolic function, 89 patients with DD) and their diagnostic performance was tested in a validation group of 50 controls and 50 patients. The patient group with a DD Grade 1 and 2 showed longer QTc (422±24ms and 434±32ms vs. 409±25ms, p<0.0005) and shorter Tend–P and Tend–Q intervals, reflecting the electrical and mechanical diastole (240±78ms and 276±108ms vs. 373±110ms, p<0.0001; 409±85ms and 447±115ms vs. 526±119ms, p<0.0001). The PQ–interval was significantly longer in the patient group (169±28ms and 171±38ms vs. 153±22ms, p<0.005). After adjusting for possible confounders, a novel index (Tend–P/PQxAge]) showed a high performance for the recognition of DD, stayed robust in the validation group (sensitivity 82%, specificity 93%, positive predictive value 93%, negative predictive value 82%, accuracy 88%) and proved a substantial added value when combined with the indexed left atrial volume (LAESVI, sensitivity 90%, specificity 92%, positive predictive value 95%, negative predictive value 86%, accuracy 91%).ConclusionsA novel electrocardiographic index Tend–P/(PQxAge) demonstrates a high diagnostic accuracy for the diagnosis of DD and yields a substantial added value when combined with the LAESVI. |
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