Changes in surface electrocardiogram in patients with chronic thromboembolic pulmonary hypertension undergoing pulmonary endarterectomy. Correlations with hemodynamic and echocardiographic improvements after surgery

J Electrocardiol. 2016 Mar-Apr;49(2):223-30. doi: 10.1016/j.jelectrocard.2015.12.006. Epub 2015 Dec 23.

Abstract

Background: The aim of the present study was to evaluate the changes of electrocardiographic (ECG) markers of right ventricular (RV) hypertrophy/overload in patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing pulmonary endarterectomy (PEA).

Methods and results: We evaluated 99 CTEPH patients who underwent PEA. P wave amplitude in DII, R wave amplitude in V1 and the number of patients with negative T wave in V1-V3 decreased significantly at 1month after surgery with no further change at 1year, in parallel with the rapid improvement in right heart hemodynamics. S wave amplitude in V1, R:S wave ratio in lead V6 and prevalence of SIQIII pattern improved significantly at 1year, in parallel with the progressive reverse remodeling of the right ventricle at echocardiography.

Conclusions: The study shows that some of the ECG markers of RV hypertrophy/overload better reflect RV hemodynamic overload while others better reflect the pathologic remodeling of the right ventricle.

Keywords: Electrocardiogram; Pulmonary hypertension.

Publication types

  • Clinical Trial

MeSH terms

  • Chronic Disease
  • Echocardiography / methods
  • Electrocardiography / methods*
  • Endarterectomy*
  • Female
  • Humans
  • Hypertension, Pulmonary / diagnosis*
  • Hypertension, Pulmonary / surgery*
  • Male
  • Middle Aged
  • Pulmonary Artery / diagnostic imaging*
  • Pulmonary Artery / surgery*
  • Pulmonary Embolism / diagnosis*
  • Pulmonary Embolism / surgery*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Statistics as Topic
  • Treatment Outcome
  • Ventricular Dysfunction, Right / diagnosis
  • Ventricular Dysfunction, Right / surgery