How accurate can electrocardiogram predict left ventricular diastolic dysfunction?

Background Heart failure continues to be a major challenge to healthcare; several resting and exercise electrocardiographic parameters have been investigated to predict the left ventricular diastolic dysfunction (LVDD). Objectives We aimed to study different parameters in resting and exercise stress test to evaluate whether they can predict left ventricular diastolic dysfunction (LVDD). Methods One hundred and forty patients, classified into 2 groups according to LVDD, were assessed by measurement of normal and corrected QT interval , T wave peak to T wave End and P wave dispersion in resting ECG. Exercise stress test looking for hump sign (upward deflection of the ST-segment) was done. The relationships between these ECG parameters and LVDD were investigated. Results We found significant occurrence of hump sign in patients with LVDD, and there was a significant difference between both groups regarding QTc and P wave dispersion. P wave dispersion was significantly higher in patients with LVDD. Sensitivity and specificity of the ST hump sign in prediction of LVDD were 86% and 78% respectively. We also concluded that P wave dispersion at cutoff value about 0.045 ms had the highest sensitivity (sensitivity 98%, specificity 64%) while QTc at cutoff value 0.395 ms had the highest specificity (sensitivity 81%, specificity 79%). Conclusion P wave dispersion and hump sign were the most sensitive ECG signs for the prediction of LVDD.