Assessment and Validation of Electrocardiographic Diastolic Index for Diagnosing Left Ventricular Diastolic Dysfunction in Patients with Hypertension

Background: Left ventricular diastolic dysfunction (LVDD) is the main cause of heart failure with preserved ejection fraction. The structural changes in the heart caused by hypertension could accelerate LVDD. The electrocardiographic diastolic index (EDI), which is calculated from ECG data, can reveal the relationship between left ventricular hypertrophy and LVDD. Objective: To analyse EDI in diagnosing LVDD in patients with hypertension. Method: This study was a-single centre, retrospective study, included 50 consecutive patients with hypertension between January – October 2023. Patients were categorized as LVDD and no LVDD group. The EDI was calculated as [R amplitude in aVL × (S amplitude in V1 + R amplitude in V5)/P wave amplitude in lead I]. The EDI greater than 7.4 mV was considered as sign of LVDD. Patients with LVEF<55%, congenital heart disease, infiltrative cardiomyopathy, coronary artery disease, chronic kidney disease, valvular heart disease, bundle branch block, arrhythmia, and missing hospital data were excluded. Result: The patients were categorized into two groups based on the presence of LVDD. The mean age of the study was 57 ± 11 years, with 14 patients of the participants being male. The patient’s EDI value was 8.6 ± 6.2. The EDI value of the LVDD group exhibited a significantly higher than no LVDD group (p=0.002). EDI could predict LVDD with 73.53% sensitivity, 75% specificity, and 74% accuracy. Conclusion: The EDI could be assessment tool for diagnosing LVDD in patients with hypertension due to its cost-effectiveness, availability, and easy-to-use formula.