Key result
Novel ECG score detects right ventricular dysfunction in stable pulmonary embolism with ~0.82 AUC.
Why the study?
Risk stratification of hemodynamically stable patients with pulmonary embolism is essential, and the ability of an ECG scoring system to predict right ventricle dysfunction or clot load was unclear.
Does an ECG scoring system predict right ventricle dysfunction and clot load in hemodynamically stable patients with pulmonary embolism?
Observational (n=103)
Does an ECG scoring system predict right ventricle dysfunction and clot load in hemodynamically stable patients with pulmonary embolism?
Effect estimate: AUC 0.82 (95% CI 0.72-0.89)
An ECG scoring system correlates with pulmonary embolism severity and right ventricular dysfunction in hemodynamically stable patients, offering a potential tool for risk stratification.
BACKGROUND: Risk stratification of patients with pulmonary embolism (PE) is essential to guide therapy. The presence of right ventricle dysfunction (RVD) and the anatomic extent of PE have been suggested to predict clinical course. The aim of this study was to assess the ability of an electrocardiogram (ECG) scoring system to predict RVD or the clot load score in normotensive patients with PE. METHODS: Consecutive patients presenting to the emergency room with PE and hemodynamic stability were prospectively included. ECG, echocardiography and computed tomography pulmonary angiography (CTPA) were performed on all patients. RESULTS: A total of 103 patients were studied. ECG score correlated significantly with the clot load score (r = 0.41, 95% confidence interval [CI]: 0.22-0.57, P < 0.001), systolic pulmonary artery pressure (r= 0.31, 95% CI: 0.09-0.49, P = 0.006), pulmonary artery diameter (r = 0.28, 95% CI: 0.07-0.47, P = 0.011) and right ventricle to left ventricle ratio, both measured with echocardiography (r = 0.42, 95% CI: 0.22-0.57, P < 0.001) and with CTPA (r= 0.36, 95% CI: 0.13-0.56, P = 0.004). Area under the receiver operating characteristic curve for detecting RVD was 0.82 (95% CI: 0.72-0.89). Interobserver agreement regarding ECG score was substantial (κ = 0.80). CONCLUSIONS: ECG score correlates with the severity of PE in hemodynamically stable patients. It is potentially useful for risk-stratification strategies in this setting.
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Golpe et al. (2011) conducted an observational in Pulmonary embolism (n=103). Electrocardiogram (ECG) scoring system was evaluated on Detection of right ventricle dysfunction (RVD) (AUC 0.82, 95% CI 0.72-0.89). An electrocardiogram scoring system detected right ventricle dysfunction with an area under the curve of 0.82 (95% CI 0.72-0.89) in hemodynamically stable patients with pulmonary embolism.
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