Electrocardiographic changes in patients responding to treatment with group i pulmonary arterial hypertension

David Snipelisky, Charles Dwayne Burger, Brian P Shapiro, Fred Kusumoto

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND: Various changes in conductivity as reflected in the electrocardiogram (ECG) have been associated with the onset and progression of pulmonary arterial hypertension (PAH). Little data exist as to whether the ECG can be used to identify patients responding to treatment. METHODS: A retrospective chart review of patients diagnosed by right-sided cardiac catheterization as having group I PAH within the past 5 years was performed. A total of 121 patients were reviewed, of whom 36 were found to be responders to treatment and were included in our study. Patients were defined as responders by evidence of symptomatic improvement and decrease in right ventricular systolic pressure by at least 15%. RESULTS: Of 36 patients included, the majority were women (n = 26, 72%) with an average age of 59.6 years. Significant differences in right-sided heart pressures based on echocardiogram were noted between the pretreatment and posttreatment subsets, with a decrease in right atrial pressure from 12.7 to 7.6 mm Hg (P = 0.0035), right ventricular systolic pressure from 83.2 to 55.3 mm Hg (P < 0.0001), and estimated pulmonary arterial mean pressure from 53.8 to 38.9 mm Hg (P < 0.0001). Electrocardiographic parameters, including resting heart rate (80 vs 76 bpm; P = 0.3683), QRS duration (98 vs 99 msec; P = 0.8444), calculated QT interval (461 vs 454 msec; P = 0.4386), premature ventricular contractions (n = 0 vs 2; P = 0.1558), right axis deviation (n = 14 versus 14; P = 1.00), right bundle branch block (n = 13 vs 7; P = 0.1176), and various measurements of right ventricular hypertrophy showed no difference. CONCLUSIONS: Although the ECG may be useful in helping to evaluate the onset and progression of PAH, its utility is limited in assessing appropriate response to treatment in this patient population.

Original languageEnglish (US)
Pages (from-to)618-623
Number of pages6
JournalSouthern Medical Journal
Volume106
Issue number11
DOIs
StatePublished - Nov 2013

Fingerprint

Pulmonary Hypertension
Electrocardiography
Ventricular Pressure
Blood Pressure
Right Ventricular Hypertrophy
Therapeutics
Atrial Pressure
Ventricular Premature Complexes
Bundle-Branch Block
Patient Rights
Cardiac Catheterization
Arterial Pressure
Heart Rate
Pressure
Lung
Population

Keywords

  • conduction abnormalities
  • electrocardiogram
  • electrophysiology
  • pulmonary arterial hypertension

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Electrocardiographic changes in patients responding to treatment with group i pulmonary arterial hypertension. / Snipelisky, David; Burger, Charles Dwayne; Shapiro, Brian P; Kusumoto, Fred.

In: Southern Medical Journal, Vol. 106, No. 11, 11.2013, p. 618-623.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Various changes in conductivity as reflected in the electrocardiogram (ECG) have been associated with the onset and progression of pulmonary arterial hypertension (PAH). Little data exist as to whether the ECG can be used to identify patients responding to treatment. METHODS: A retrospective chart review of patients diagnosed by right-sided cardiac catheterization as having group I PAH within the past 5 years was performed. A total of 121 patients were reviewed, of whom 36 were found to be responders to treatment and were included in our study. Patients were defined as responders by evidence of symptomatic improvement and decrease in right ventricular systolic pressure by at least 15{\%}. RESULTS: Of 36 patients included, the majority were women (n = 26, 72{\%}) with an average age of 59.6 years. Significant differences in right-sided heart pressures based on echocardiogram were noted between the pretreatment and posttreatment subsets, with a decrease in right atrial pressure from 12.7 to 7.6 mm Hg (P = 0.0035), right ventricular systolic pressure from 83.2 to 55.3 mm Hg (P < 0.0001), and estimated pulmonary arterial mean pressure from 53.8 to 38.9 mm Hg (P < 0.0001). Electrocardiographic parameters, including resting heart rate (80 vs 76 bpm; P = 0.3683), QRS duration (98 vs 99 msec; P = 0.8444), calculated QT interval (461 vs 454 msec; P = 0.4386), premature ventricular contractions (n = 0 vs 2; P = 0.1558), right axis deviation (n = 14 versus 14; P = 1.00), right bundle branch block (n = 13 vs 7; P = 0.1176), and various measurements of right ventricular hypertrophy showed no difference. CONCLUSIONS: Although the ECG may be useful in helping to evaluate the onset and progression of PAH, its utility is limited in assessing appropriate response to treatment in this patient population.",
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