PURPOSE: Idiopathic arterial pulmonary hypertension (IPAH) is a rare condition that causes right ventricular (RV) chronic overload pressure and RV hypertrophy (RVH), the electrocardiogram (EKG) is frequently used as a RVH screening tool, but its concordance with magnetic resonance image (MRI)hasn't been studied yet. In order to know the concordance between EKG RVH index and MRI in IPAH patients we realized this study.
METHODS: 17 IPAH patients were paired with 17 healthy subjects by sex, gender and body mass index. We obtained from both EKG and RMI data. Free wall right ventricular thickening was measured and RVH was defined as >0.7cm. Data are informed as mean ± standard deviation (M±SD), differences between groups were obtained with paired t-test and the agreement with Kappa statistics.
RESULTS: Age IPAH Group was 38.2±11.5 vs 37.3±13.2 in the control group, in IPAH group mean pulmonary arterial pressure was 66±18mmHg. ECG findings were: heart rate 80.35±9.99 vs. 70.45±11.21, p<0.027, QRS axis 131± 6 vs. 43±23 p<0.000, P axis 52±14 vs. 33±11, p<0.002, P height 1.82±0.47 vs. 0.95±0.26, p<0.000, Qt corrected segment 0.45±0.05 vs. 0.43±0.03, p<0.21, Sokolow-Lyons′s index 14.06±3.5 vs. 2.05±2.56, p<0.000; Cabrera′s index 0.81±0.24 vs. 0.16±0.09, p<0.000, Lewis′s index -14.60±5.54 vs. 4.93±3.38, p<0.000. Agreement for RVH are shown in Table I.
CONCLUSION: Right axis deviation and RVH were observed in EKG. Sokolow-Lyons and Cabrera's index showed good agreement for RVH with MRI.
CLINICAL IMPLICATIONS: Although EKG lack sufficient diagnostic accuracy for the detection of pulmonary arterial hypertension, we can use the EKG, Sokolow-Lyons′s index and Cabrera's index as screening tool suggestive of RV morphological changes due to chronic RV overload pressure.
DISCLOSURE: Fernando Flores-Figueroa, None.