The ECG-derived Butler-Leggett score correlated with CMR-derived right ventricular mass (r=0.77, P<0.001), and a score >0.7 mV was 100% specific but 61-74% sensitive for detecting RV hypertrophy.
Observational (n=28)
Does the 12-lead ECG-derived Butler-Leggett score accurately estimate right ventricular mass and detect right ventricular hypertrophy compared to cardiac MRI in patients with pulmonary arterial hypertension?
The ECG-derived Butler-Leggett score correlates well with CMR-derived right ventricular mass in PAH patients and is highly specific, though insensitive, for detecting right ventricular hypertrophy.
Effect estimate: r=0.77
p-value: p=<0.001
In patients with pulmonary arterial hypertension (PAH), right ventricular mass (RVM) correlates linearly with pulmonary artery pressure, and decreases with successful treatment. Accurate measurement of RVM currently requires cardiovascular magnetic resonance (CMR) imaging. We therefore tested the relationship between RVM and a simple, 12 lead ECG-derived value, the Butler-Leggett (BL) score. This has previously been validated in patients with RV hypertrophy (RVH) due to mitral stenosis. We also tested the diagnostic accuracy of the BL score in detecting RVH. The Scottish Pulmonary Vascular Unit database was reviewed retrospectively. Twenty-eight patients with PAH were identified, in whom CMR and ECG data had been recorded no more than 28 days apart. All had completed a comprehensive clinical assessment, including right heart catheterization. CMR-derived absolute RVM and RV mass index (RVMI=RV mass/LV mass) were correlated against BL score. The ability of this score to detect RVH was tested using 2 x 2 contingency tables. RVM and RVMI correlated with BL score (r=0.77, P0.7 mV proved a highly specific but insensitive indicator of RVH, based on either absolute RVM (sensitivity 74%, specificity 100%) or a high RVMI (sensitivity 61%, specificity 100%). The BL score, which can be defined using a standard 12-lead ECG, correlates with RVM and RVMI in patients with PAH. A score >0.7 mV was a highly specific but insensitive indicator of RVH in these patients.
Blyth et al. (Sat,) conducted a observational in pulmonary arterial hypertension (PAH) (n=28). Butler-Leggett (BL) score vs. Cardiovascular magnetic resonance (CMR) imaging was evaluated on Correlation between CMR-derived absolute right ventricular mass (RVM) and BL score (r=0.77, p=<0.001). The ECG-derived Butler-Leggett score correlated with CMR-derived right ventricular mass (r=0.77, P<0.001), and a score >0.7 mV was 100% specific but 61-74% sensitive for detecting RV hypertrophy.