Key result
An ECG risk score of ≥ 2, incorporating tachycardia, ST-T-wave abnormalities, and prolonged QRS duration, predicted peripartum cardiomyopathy with an area under the curve of 83.8%.
Why the study?
Do electrocardiographic parameters and a derived risk score predict the presence of peripartum cardiomyopathy in postpartum women?
Case-Control (n=131)
Yes
Do electrocardiographic parameters and a derived risk score predict the presence of peripartum cardiomyopathy in postpartum women?
Effect estimate: AUC 83.8% (95% CI 76.4-91.2)
p-value: p=<0.0001
A simple ECG-based risk score incorporating tachycardia, ST-T-wave abnormalities, and QRS duration can help streamline the diagnosis of peripartum cardiomyopathy in postpartum women.
ECG risk score may aid PPCM detection postpartum; hypothesis-generating and requires prospective validation before clinical use.
OBJECTIVE: To identify potential electrocardiographic predictors of peripartum cardiomyopathy (PPCM). METHODS: This was a case-control study carried out in three hospitals in Kano, Nigeria. Logistic regression models and a risk score were developed to determine electrocardiographic predictors of PPCM. RESULTS: A total of 54 PPCM and 77 controls were consecutively recruited after satisfying the inclusion criteria. After controlling for confounding variables, a rise in heart rate of one beat/minute increased the risk of PPCM by 6.4% (p = 0.001), while the presence of ST-T-wave changes increased the odds of PPCM 12.06-fold (p < 0.001). In the patients, QRS duration modestly correlated (r = 0.4; p < 0.003) with left ventricular dimensions and end-systolic volume index, and was responsible for 19.9% of the variability of the latter (R(2) = 0.199; p = 0.003). A risk score of ≥ 2, developed by scoring 1 for each of the three ECG disturbances (tachycardia, ST-T-wave abnormalities and QRS duration), had a sensitivity of 85.2%, specificity of 64.9%, negative predictive value of 86.2% and area under the curve of 83.8% (p < 0.0001) for potentially predicting PPCM. CONCLUSION: In postpartum women, using the risk score could help to streamline the diagnosis of PPCM with significant accuracy, prior to confirmatory investigations.
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Karaye et al. (2016) conducted a case-control in Peripartum cardiomyopathy (n=131). ECG risk score vs. Healthy postpartum women was evaluated on Prediction of PPCM using an ECG risk score ≥ 2 (AUC 83.8%, 95% CI 76.4-91.2, p=<0.0001). An ECG risk score of ≥ 2, incorporating tachycardia, ST-T-wave abnormalities, and prolonged QRS duration, predicted peripartum cardiomyopathy with an area under the curve of 83.8%.
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