Detection of elevated pulmonary pressures by the ECG-derived ventricular gradient: A comparison of conversion matrices in patients with suspected pulmonary hypertension

Marlieke L A Haeck; Gijsbert F L Kapel; Roderick W C Scherptong; Cees A Swenne; Arie C Maan; Jeroen J Bax; Martin J Schalij; Hubert W Vliegen

doi:10.1016/j.jelectrocard.2016.09.002

Detection of elevated pulmonary pressures by the ECG-derived ventricular gradient: A comparison of conversion matrices in patients with suspected pulmonary hypertension

J Electrocardiol. 2017 Jan-Feb;50(1):115-122. doi: 10.1016/j.jelectrocard.2016.09.002. Epub 2016 Sep 8.

Authors

Marlieke L A Haeck¹, Gijsbert F L Kapel¹, Roderick W C Scherptong¹, Cees A Swenne¹, Arie C Maan¹, Jeroen J Bax¹, Martin J Schalij¹, Hubert W Vliegen²

Affiliations

¹ Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
² Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: h.w.vliegen@lumc.nl.

PMID: 27742061
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 ≥50mmHg 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 ≥50mmHg 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 ≥50mmHg (INVD, OR 1.05, 95%CI 1.03-1.07; P<0.001; Kors, OR 1.05, 95%CI 1.03-1.08; P<0.001).

Conclusion: Although there were significant differences in measures of vector morphology, both INVD- and Kors-derived VCG demonstrated equal clinical performance in case of elevated SPAP.

Keywords: Electrocardiogram; Pulmonary hypertension; Ventricular gradient.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Algorithms*
Blood Pressure Determination / methods*
Diagnosis, Computer-Assisted / methods*
Electrocardiography / methods*
Female
Humans
Hypertension, Pulmonary / diagnosis*
Male
Middle Aged
Reproducibility of Results
Sensitivity and Specificity
Vectorcardiography / methods*