A novel electrocardiographic index for the diagnosis of diastolic dysfunction

Contains fulltext : 128595.pdf (publisher's version ) (Open Access)BACKGROUND: Although the assessment of diastolic dysfunction (DD) is an integral part of routine cardiologic examinations, little is known about associated electrocardiographic (ECG) changes. Our aim was to investigate a potential role of ECG indices for the recognition of patients with DD. METHODS AND RESULTS: ECG parameters correlating with echocardiographic findings of DD were retrospectively assessed in a derivation group of 172 individuals (83 controls with normal diastolic function, 89 patients with DD) and their diagnostic performance was tested in a validation group of 50 controls and 50 patients. The patient group with a DD Grade 1 and 2 showed longer QTc (422+/-24ms and 434+/-32ms vs. 409+/-25ms, p<0.0005) and shorter Tend-P and Tend-Q intervals, reflecting the electrical and mechanical diastole (240+/-78ms and 276+/-108ms vs. 373+/-110ms, p<0.0001; 409+/-85ms and 447+/-115ms vs. 526+/-119ms, p<0.0001). The PQ-interval was significantly longer in the patient group (169+/-28ms and 171+/-38ms vs. 153+/-22ms, p<0.005). After adjusting for possible confounders, a novel index (Tend-P/[PQxAge]) showed a high performance for the recognition of DD, stayed robust in the validation group (sensitivity 82%, specificity 93%, positive predictive value 93%, negative predictive value 82%, accuracy 88%) and proved a substantial added value when combined with the indexed left atrial volume (LAESVI, sensitivity 90%, specificity 92%, positive predictive value 95%, negative predictive value 86%, accuracy 91%). CONCLUSIONS: A novel electrocardiographic index Tend-P/(PQxAge) demonstrates a high diagnostic accuracy for the diagnosis of DD and yields a substantial added value when combined with the LAESVI