A Novel Electrocardiographic Index for the Diagnosis of Diastolic Dysfunction

作者：Namdar Mehdi^*; Biaggi Patric; Staehli Barbara; Buetler Bernhard; Casado Arroyo Ruben; Ricciardi Danilo; Rodriguez Manero Moises; Steffel Jan; Huerlimann David; Schmied Christian; de Asmundis Carlo; Chierchia Gian Battista; Sarkozy Andrea; Luescher Thomas F; Jenni Rolf; Duru Firat; Paulus Walter J; Brugada Pedro

来源：PLos One, 2013, 8(11): UNSP e79152.

DOI：10.1371/journal.pone.0079152

Background: Although the assessment of diastolic dysDD) 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. %26lt;br%26gt;Methods and Results: ECG 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%26lt;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%26lt;0.0001; 409 +/- 85ms and 447 +/- 115ms vs. 526 +/- 119ms, p%26lt;0.0001). The PQ-interval was significantly longer in the patient group (169 +/- 28ms and 171 +/- 38ms vs. 153 +/- 22ms, p%26lt;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%). %26lt;br%26gt;Conclusions: A 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.

• 出版日期2013-11-5