The Effects of Flosequinan on Hemodynamics and Oxygen Delivery in Cor Pulmonale

Elborn, J. Stuart; Richardson, G. S.; Murphy, P J; MacMahon, J.

doi:10.1378/chest.102.4.1155

Cited by 2 publications

(1 citation statement)

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“…1–6 As the diagnosis of pulmonary hypertension is frequently delayed 7 and even mild RVH is an independent predictor of heart failure and cardiovascular death, 8 early detection of RVH could facilitate treatment and potentially improve outcomes. 7,9 Nonetheless, screening strategies in the general population are limited.…”

Section: Introductionmentioning

confidence: 99%

Validity of the Surface Electrocardiogram Criteria for Right Ventricular Hypertrophy

Whitman

Patel

Soliman

et al. 2014

Journal of the American College of Cardiology

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Objectives We aimed to assess the diagnostic properties of ECG criteria for RVH measured by cardiac magnetic resonance imaging (cMRI) in adults without clinical cardiovascular disease. Background Current electrocardiographic (ECG) criteria for right ventricular hypertrophy (RVH) were based on cadaveric dissection in small studies. Methods The Multi-Ethnic Study of Atherosclerosis performed cMRIs with complete right ventricle (RV) interpretation on 4,062 participants without clinical cardiovascular disease. Endocardial margins of the RV were manually contoured on diastolic and systolic images. The ECG screening criteria for RVH from the 2009 AHA Recommendations for Standardization and Interpretation of the ECG were examined in participants with and without left ventricular hypertrophy or reduced ejection fraction. RVH was defined using sex-specific normative equations based on age, height, and weight. Results The study sample with normal left ventricular morphology and function (n = 3,719) was 61.3 ± 10.0 years old, 53.5% female, 39.6% Caucasian, 25.5% African-American, 21.9% Hispanic, and 13.0% Asian. The mean BMI was 27.9 ± 5.0 kg/m2. Six percent had RVH which was generally mild. Traditional ECG criteria were specific (many > 95%) but had low sensitivity for RVH by cMRI. The positive predictive values were not sufficiently high as to be clinically useful (maximum 12%). The results did not differ based on age, sex, race, smoking status, or with including participants with abnormal LV mass or function. Classification and regression tree analysis revealed that no combination of ECG variables was better than the criteria used singly. Conclusions The recommended ECG screening criteria for RVH are not sufficiently sensitive or specific for screening for mild RVH in adults without clinical cardiovascular disease.

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