Department of Cardiology, Adana Çukurova State Hosipital, Adana, Turkey.
Department of Cardiology, Osmaniye State Hospital, Osmaniye, Turkey.
Med Princ Pract. 2022;31(5):463-470. doi: 10.1159/000525433. Epub 2022 Jun 9.
The occurrence of right ventricular (RV) dysfunction in chronic obstructive pulmonary disease (COPD) results in an increased risk of mortality. We aimed to study the diagnostic value of RS time in the recognition of COPD patients with RV dysfunction.
120 consecutive COPD patients were divided into two groups, patients with and without RV dysfunction, and compared them in terms of parameters including RS time. RS time was defined as the longest interval from the beginning of the QRS complex to the nadir of the S- or S'-wave in the inferolateral leads on an electrocardiogram.
RV dysfunction was observed in 36% of consecutive COPD patients with a mean age of 63.4 ± 9.8 years (83.3% male) and a mean forced expiratory volume in 1 s of 1.51 ± 0.62 lt. The heart rate, right QRS axis deviation frequency, S1S2S3 pattern frequency, and RS time (p < 0.01) were significantly higher in the patients with RV dysfunction than in those without. Body surface area, heart rate, and RS time (p < 0.001) were independent predictors of an RV dysfunction. An ROC analysis showed that the best RS time cutoff value for the prediction of RV dysfunction was 60 ms with a sensitivity of 81.4% and a specificity of 74.0%.
In patients with COPD, RS time prolongation, which can be easily and quickly determined from the electrocardiogram, may be a marker for RV dysfunction.
慢性阻塞性肺疾病(COPD)患者右心室(RV)功能障碍的发生会增加死亡率。我们旨在研究 RS 时间在识别 COPD 合并 RV 功能障碍患者中的诊断价值。
120 例连续 COPD 患者分为两组,RV 功能正常和 RV 功能障碍患者,并比较两组患者的 RS 时间等参数。RS 时间定义为心电图下外侧导联 QRS 波起始至 S 波或 S'波最低点的最长间隔。
连续 COPD 患者中 36%存在 RV 功能障碍,平均年龄为 63.4 ± 9.8 岁(83.3%为男性),1 秒用力呼气量(FEV1)为 1.51 ± 0.62 lt。RV 功能障碍患者的心率、右 QRS 轴偏离频率、S1S2S3 模式频率和 RS 时间(p < 0.01)均显著高于 RV 功能正常患者。体表面积、心率和 RS 时间(p < 0.001)是 RV 功能障碍的独立预测因子。ROC 分析显示,预测 RV 功能障碍的最佳 RS 时间截断值为 60 ms,其敏感性为 81.4%,特异性为 74.0%。
在 COPD 患者中,心电图上容易且快速确定的 RS 时间延长可能是 RV 功能障碍的标志物。