QRS-T angle as a predictor of pulmonary arterial hypertension: A review

Abstract

Spatial QRS-T angle is a vector projection of ventricular gradient, reflecting the heterogeneity of ventricular repolarization. The QRS vector is projected into three dimensional (3D) space to obtain the frontal QRS f vector and Tf vector. The frontal QRS-T Angle can be obtained by simple calculation. In several studies of diseases that cause pulmonary hypertension, there has been evidence that changes in the QRS-T Angle can predict disease. Electrocardiogram (ECG) is a cheap and noninvasive test, and its clinical significance in the diagnosis of pulmonary hypertension should be further studied.

Pulmonary arterial sarcoma: A case report

“…[14,15] At the time of diagnosis, approximately 50% of patients already have lung metastases, and 16% have distant metastases. [3,11,12] In this case, the patient had scattered small nodules in the lungs with a partial increase in metabolic activity on positron emission computed tomography, suggesting pulmonary metastases. Treatment options for PAS include surgery, chemotherapy, radiotherapy, and immunotherapy.…”

“…The most common pathological type of PAS is undifferentiated sarcoma (34%), followed by fibrosarcoma (21%), smooth muscle sarcoma (20%), rhabdomyosarcoma (6%), mesenchymal histiocytoma (6%), intrachondral sarcoma (4%), angiosarcoma (4%), osteosarcoma (3%), and malignant fibrous histiocytoma (2%). [11,12] Among these, smooth muscle sarcoma generally has a better prognosis, while rhabdomyosarcoma has the poorest prognosis, typically resulting in death within 3 months after surgery. Undifferentiated tumors fall in between in terms of malignancy.…”

“…[11,12] In a specific case, the pathological diagnosis was undifferentiated pleomorphic sarcoma of the pulmonary artery, accounting for approximately one-third of all PAS, this type of sarcoma is characterized by a large mass originating from the main pulmonary artery outside the lungs, often growing into the blood vessel lumen as a polypoid mass. [11,12] Dewaele et al [6,13] suggests that the development of PAS may be associated with the presence of endosomal sarcomas and the overexpression of certain genes, such as platelet-derived growth factor receptor, MDM2, CKD4, SAS, and sustained activation of the epidermal growth factor receptor. [13,14] Inhibition of MDM2 has been proposed as a potential therapeutic target for patients with MDM2(+).…”

“…Pathological biopsy is considered the gold standard for diagnosing this disease, and the patient underwent this procedure. [10–12] Subsequently, the patient was referred to a higher-level hospital for pulmonary endarterectomy. The postoperative pathology confirmed the presence of undifferentiated pleomorphic sarcoma of the pulmonary artery, providing a definitive diagnosis of pulmonary artery sarcoma.…”

“…[3,8,9] The exact causes and underlying mechanisms of PAS are still unknown. Hagwat et al [1,10,11] have suggested that PAS may originate from multipotent mesenchymal cells with the ability to differentiate in multiple directions, potentially derived from the embryonic cardiac balloon myogenic material. The most common pathological type of PAS is undifferentiated sarcoma (34%), followed by fibrosarcoma (21%), smooth muscle sarcoma (20%), rhabdomyosarcoma (6%), mesenchymal histiocytoma (6%), intrachondral sarcoma (4%), angiosarcoma (4%), osteosarcoma (3%), and malignant fibrous histiocytoma (2%).…”