Vol 69, No 9 (2011)
Original articles
Published online: 2011-09-19
The value of ECG parameters in estimating myocardial injury and establishing prognosis in patients with acute pulmonary embolism
DOI: 10.33963/v.kp.79177
Kardiol Pol 2011;69(9):933-938.
Abstract
Background: The electrocardiogram (ECG) is characterised by little sensitivity and specificity in the diagnostic evaluation of
acute pulmonary embolism (APE).
Aim: To assess the significance of ECG changes in predicting myocardial injury and prognosis in patients with APE.
Methods: The study group consisted of 225 patients (137 women and 88 men), mean age: 66.0 ± 15.2 years, in whom the diagnosis of APE was made, mostly based on computed tomography (n = 206, 92%).
Results: We observed 26 in-hospital deaths (mortality rate: 11.5%) and complications occurred in 58 (25.7%) patients. Elevated levels of troponin were observed in 103 (46%) patients. Logistic regression analysis showed that in-hospital mortality was associated with: coronary chest pain (0.06–0.53, OR 0.18), systolic blood pressure below 100 mm Hg (2.3–13.64, OR 5.61), heart rate above 100 bpm (1.17–15.11, OR 4.21), the S1Q3T3 sign (1.31–6.99, OR 3.02), QR in V1 (1.60–12.32, OR 4.45), ST-segment depression in V4–V6 (0.99–5.40, OR 2.31), ST-segment elevation in III (0.99–6.96, OR 2.64), ST-segment elevation in V1 (1.74–9.49, OR 4.07); borderline (1.51–16.07, OR 4.93), moderate (1.42–17.74, OR 5.01) and severe troponin elevation (2.88–36.38, OR 10.24). In patients with cTnT(+), compared to patients with normal troponin levels, the following ECG changes were significantly more common: the S1Q3T3 sign (43 vs 21%, p = 0.003), negative T waves in V2–V4 (57 vs 27%, p = 0.0001), ST-segment depression in V4–V6 (40 vs 14%, p = 0.001), ST-segment elevation in III (22 vs 7%, p = 0.0006), V1 and V2 (43 vs 10%, p = 0.0001) and QR in V1 (16 vs 5%, p = 0.007).
Conclusions: ECG parameters are useful in predicting myocardial injury and assessing prognosis in patients with APE.
Kardiol Pol 2011; 69, 9: 933–938
Aim: To assess the significance of ECG changes in predicting myocardial injury and prognosis in patients with APE.
Methods: The study group consisted of 225 patients (137 women and 88 men), mean age: 66.0 ± 15.2 years, in whom the diagnosis of APE was made, mostly based on computed tomography (n = 206, 92%).
Results: We observed 26 in-hospital deaths (mortality rate: 11.5%) and complications occurred in 58 (25.7%) patients. Elevated levels of troponin were observed in 103 (46%) patients. Logistic regression analysis showed that in-hospital mortality was associated with: coronary chest pain (0.06–0.53, OR 0.18), systolic blood pressure below 100 mm Hg (2.3–13.64, OR 5.61), heart rate above 100 bpm (1.17–15.11, OR 4.21), the S1Q3T3 sign (1.31–6.99, OR 3.02), QR in V1 (1.60–12.32, OR 4.45), ST-segment depression in V4–V6 (0.99–5.40, OR 2.31), ST-segment elevation in III (0.99–6.96, OR 2.64), ST-segment elevation in V1 (1.74–9.49, OR 4.07); borderline (1.51–16.07, OR 4.93), moderate (1.42–17.74, OR 5.01) and severe troponin elevation (2.88–36.38, OR 10.24). In patients with cTnT(+), compared to patients with normal troponin levels, the following ECG changes were significantly more common: the S1Q3T3 sign (43 vs 21%, p = 0.003), negative T waves in V2–V4 (57 vs 27%, p = 0.0001), ST-segment depression in V4–V6 (40 vs 14%, p = 0.001), ST-segment elevation in III (22 vs 7%, p = 0.0006), V1 and V2 (43 vs 10%, p = 0.0001) and QR in V1 (16 vs 5%, p = 0.007).
Conclusions: ECG parameters are useful in predicting myocardial injury and assessing prognosis in patients with APE.
Kardiol Pol 2011; 69, 9: 933–938
Keywords: acute pulmonary embolismECGtroponincomplications
