* Corresponding Author
Scoring system based on electrocardiogram features to predict the type of heart failure in patients with chronic heart failure
https://doi.org/10.19106/JMedSci004803201601 Hendry Purnasidha Bagaswoto(1*), Lucia Kris Dinarti(2), Erika Maharani(3)
(1) Cardiology and Vascular Department, Faculty of Medicine Gadjah Mada University-Sardjito General Hospital
(2) Cardiology and Vascular Educational Program, Faculty of Medicine / Dr. Sardjito General Hospital, Universitas Gadjah Mada, Yogyakarta
(3) Cardiology and Vascular Educational Program, Faculty of Medicine / Dr. Sardjito General Hospital, Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author
Abstract
ABSTRACT
Heart failure is divided into heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Additional studies are required to distinguish between these two types of HF. A previous study showed that HFrEF is less likely when ECG findings are normal. This study aims to create a scoring system based on ECG findings that will predict the type of HF. We performed a cross-sectional study analyzing ECG and echocardiographic data from 110 subjects. HFrEF was defined as an ejection fraction ≤40%. Fifty people were diagnosed with HFpEF and 60 people suffered from HFrEF. Multiple logistic regression analysis revealed certain ECG variables that were independent predictors of HFrEF i.e., LAH, QRS duration >100 ms, RBBB, ST-T segment changes and prolongation of the QT interval. Based on ROC curve analysis, we obtained a score for HFpEF of -1 to +3, while HFrEF had a score of +4 to +6 with 76% sensitivity, 96% specificity, 95% positive predictive value, an 80% negative predictive value and an accuracy of 86%. The scoring system derived from this study, including the presence or absence of LAH, QRS duration >100 ms, RBBB, ST-T segment changes and prolongation of the QT interval can be used to predict the type of HF with satisfactory sensitivity and specificity
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Vasan RS and Levy D. Heart Failure Due to Diastolic Dysfunction: Definition, Diagnosis and Treatment. In: McMurray JJV and Pfeffer MA, editor. Heart Failure Updates. United Kongdom: Martin Dunitz, 2003; p: 1-13. 2. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Horwich T, et al. Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practise Guidelines. Circulation 2013; doi:10.1161/CIR.0b013e31829e8776. 3. McMurray JV, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K, et al. ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure. Eur Heart J 2012; doi:10.1093/eurheartj/ehs104. 4. Ponikowski P, Jankowska EA, Banasiak W. Prognosis in Diastolic Heart Failure. In: Smiseth OA and Tendera M, editor. Diastolic Heart Failure. London: Springer-Verlag, 2008; p: 213-220. 5. Dickstein K, Filippatos G, McMurray JV, Ponikowski P, Stromberg A, Keren A, et al. ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure. Eur Heart J 2008; 29: 2388-2442, doi:10.1093/eurheartj/ehn309. 6. Davie AP, Francis CM, Love MP, Caruana L, Starkey IR. Value of the Electrocardiogram in Identifying Heart Failure Due to Left Ventricular Systolic Dysfunction. BMJ 1996; 312: 222. 7. Dahlan MS. Penelitian Prognostik dan Sistem Skoring. Jatinangor: Penerbit Alqa Prisma Interdelta, 2011; p: 49-125. 8. Young SG, Abouantoun S, Savvides M, Madsen EB, Froelicher V. Limitations of Electrocardiographic Scoring Systems for Estimation of Left Ventricular Function. J Am Coll Cardiol 1983; (6): 1479-1488. 9. Fioretti P, Brower RW, Lazzeroni E, Simoons ML, Wijns W, Reiber JHC, et al. Limitation of a QRS Scoring System to Assess Left Ventricular Function and Prognosis at Hospital Discharge After Myocardial Infarction. Br Heart J 1985; 53: 248-252. 10. Paulus WJ and Tschope C. A Novel Paradigm for Heart Failure With Preserved Ejection Fraction. J Am Coll Cardiol 2013; 62: 263-271. 11. Tsutsui H, Tsuchihashi-Makaya M, Kinugawa S. Clinical Characteristics and Outcomes of Heart Failure With Preserved Ejection Fraction: Lesson From Epidemiological Studies. J Cardiol 2010; 55: 13-22. 12. Chatterjee K and Massie B. Systolic and Diastolic Heart Failure: Differences and Similarities. J Card Fail 2007; Vol. 13, No.7. 13. Karaye KM and Sani MU. Electrocardiographic Abnormalities in Patients With Heart Failure. Cardiovasc J Afr 2008; 19: 22-25. 14. Murkofsky RL, Dangas G, Diamond JA, Mehta D, Schaffer A, Ambrose JA. A Prolonged QRS Duration on Surface Electrocardiogram Is a Spesific Indicator of Left Ventricular Dysfunction. J Am Coll Cardiol 1998; 32: 476-482. 15. Lee DS, Gona P, Vasan RS, Larson MG, Benjamin EJ, Wang TJ, et al. Relation of Disease Etiology and Risk Factors to Heart Failure With Preserved or Reduced Ejection Fraction. Circulation 2009; 119(24): 3070-3077. 16. Sauer WH. Overview of Right Bundle Branch Block. UpToDate 19.3. 17. Surawicz B, Tavel ME, Knilans TK, Gering LE. Chou’s Electrocardiography in Clinical Practice. Philadelphia: Saunders Elsevier, 2008; p: 75-92; 29-43. 18. Basnet BK, Manandhar K, Shrestha R, Thapa M. Electrocardiograph and Chest X-Ray in Prediction of Left Ventricular Systolic Dysfunction. J Nepal Med Assoc 2009; 48(176): 310-313. 19. Nielsen OW, Hansen JF, Hilden J, Larsen CT, Svanegaard J. Risk Assessment of Left Ventricular Systolic Dysfunction in Primary Care: Cross Sectional Study Evaluating A Range of Diagnostic Tests. BMJ 2000; 320: 220-224. 20. Okin PM, Devereux RB, Nieminen MS, Oikarinen L, Jern S, Viitasalo M, et al. Relationship of the Electrocardiographic Strain Pattern to Left Ventricular Structure and Function in Hypertensive Patients: The LIFE Study. J Am Coll Cardiol 2001; 38: 514-520. 21. Wilcox JE, Rosenberg J, Vallakati A, Gheorghiade M, Shah SJ. Usefulness of Electrocardiographic QT Interval to Predict Left Ventricular Diastolic Dysfunction. Am J Cardiol 2011; 142(5): 756-759.
DOI: https://doi.org/10.19106/JMedSci004803201601
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