Key result
T-wave-based features on ECG were not correlated with serum potassium levels in real-world clinical practice (correlation coefficients ranged from -0.22 to 0.02).
Why the study?
Although T-wave changes in hyperkalemia are well known, their clinical usefulness is debatable.
Do T-wave-based features on ECG correlate with serum potassium levels in real-world clinical practice?
Observational (n=500)
No
Do T-wave-based features on ECG correlate with serum potassium levels in real-world clinical practice?
Effect estimate: r = -0.22 to 0.02
T-wave-based features on ECG do not reliably correlate with serum potassium levels in real-world clinical practice, challenging their utility for estimating potassium.
T-wave features should not guide potassium assessment; hypothesis-generating for ECG electrolyte monitoring in real-world settings.
BACKGROUND: Proper management of hyperkalemia that leads to fatal cardiac arrhythmia has become more important because of the increased prevalence of hyperkalemia-prone diseases. Although T-wave changes in hyperkalemia are well known, their usefulness is debatable. We evaluated how well T-wave-based features of electrocardiograms (ECGs) are correlated with estimated serum potassium levels using ECG data from real-world clinical practice. METHODS: We collected ECGs from a local ECG repository (MUSE™) from 1994 to 2017 and extracted the ECG waveforms. Of about 1 million reports, 124,238 were conducted within 5 minutes before or after blood collection for serum potassium estimation. We randomly selected 500 ECGs and two evaluators measured the amplitude (T-amp) and right slope of the T-wave (T-right slope) on five lead waveforms (V3, V4, V5, V6, and II). Linear correlations of T-amp, T-right slope, and their normalized feature (T-norm) with serum potassium levels were evaluated using Pearson correlation coefficient analysis. RESULTS: Pearson correlation coefficients for T-wave-based features with serum potassium between the two evaluators were 0.99 for T-amp and 0.97 for T-right slope. The coefficient for the association between T-amp, T-right slope, and T-norm, and serum potassium ranged from -0.22 to 0.02. In the normal ECG subgroup (normal ECG or otherwise normal ECG), there was no correlation between T-wave-based features and serum potassium level. CONCLUSIONS: T-wave-based features were not correlated with serum potassium level, and their use in real clinical practice is currently limited.
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Yoon et al. (2018) conducted an observational in Hyperkalemia (n=500). T-wave-based features (T-amp, T-right slope, T-norm) was evaluated on Linear correlations of T-amp, T-right slope, and T-norm with serum potassium levels (r = -0.22 to 0.02). T-wave-based features on ECG were not correlated with serum potassium levels in real-world clinical practice (correlation coefficients ranged from -0.22 to 0.02).
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