Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 8

Diagnostic electrocardiographic dyad criteria of emphysema in left ventricular hypertrophy

Authors Lanjewar SS, Chhabra L, Chaubey VK, Joshi S, Kulkarni G, Kothagundla C, Kaul S, Spodick DH

Received 28 June 2013

Accepted for publication 7 October 2013

Published 22 November 2013 Volume 2013:8 Pages 591—594

DOI https://doi.org/10.2147/COPD.S50680

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Swapnil S Lanjewar,1 Lovely Chhabra,1 Vinod K Chaubey,1 Saurabh Joshi,1 Ganesh Kulkarni,1 Chandrasekhar Kothagundla,1 Sudesh Kaul,1 David H Spodick2

1
Department of Internal Medicine, 2Department of Cardiovascular Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA, USA

Background: The electrocardiographic diagnostic dyad of emphysema, namely a combination of the frontal vertical P-vector and a narrow QRS duration, can serve as a quasidiagnostic marker for emphysema, with specificity close to 100%. We postulated that the presence of left ventricular hypertrophy in emphysema may affect the sensitivity of this electrocardiographic criterion given that left ventricular hypertrophy generates prominent left ventricular forces and may increase the QRS duration.
Methods: We reviewed the electrocardiograms and echocardiograms for 73 patients with emphysema. The patients were divided into two groups based on the presence or absence of echocardiographic evidence of left ventricular hypertrophy. The P-vector, QRS duration, and forced expiratory volume in one second (FEV1) were computed and compared between the two subgroups.
Results: There was no statistically significant difference in qualitative lung function (FEV1) between the subgroups. There was no statistically significant difference in mean P-vector between the subgroups. The mean QRS duration was significantly longer in patients with left ventricular hypertrophy as compared with those without left ventricular hypertrophy.
Conclusion: The presence of left ventricular hypertrophy may not affect the sensitivity of the P-vector verticalization when used as a lone criterion for diagnosing emphysema. However, the presence of left ventricular hypertrophy may significantly reduce the sensitivity of the electrocardiographic diagnostic dyad in emphysema, as it causes a widening of the QRS duration.

Keywords: emphysema, electrocardiogram, left ventricular hypertrophy, chronic obstructive pulmonary disease, P-vector, QRS duration

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Other articles by this author:

P-wave indices in patients with pulmonary emphysema: do P-terminal force and interatrial block have confounding effects?

Chhabra L, Chaubey VK, Kothagundla C, Bajaj R, Kaul S, Spodick DH

International Journal of Chronic Obstructive Pulmonary Disease 2013, 8:245-250

Published Date: 14 May 2013

Optimal electrocardiographic limb lead set for rapid emphysema screening

Bajaj R, Chhabra L, Basheer Z, Spodick DH

International Journal of Chronic Obstructive Pulmonary Disease 2013, 8:41-44

Published Date: 19 January 2013

Readers of this article also read:

Potential toxicity of dental nanomaterials to the central nervous system

Solla DF, Paiva TS, André M, Paiva WS

International Journal of Nanomedicine 2015, 10:5593-5596

Published Date: 3 September 2015

Comorbidity in chronic obstructive pulmonary disease. Related to disease severity?

Echave-Sustaeta JM, Comeche Casanova L, Cosio BG, Soler-Cataluña JJ, Garcia-Luján R, Ribera X

International Journal of Chronic Obstructive Pulmonary Disease 2014, 9:1307-1314

Published Date: 19 November 2014

Clinical issues of mucus accumulation in COPD

Ramos FL, Krahnke JS, Kim V

International Journal of Chronic Obstructive Pulmonary Disease 2014, 9:139-150

Published Date: 24 January 2014

Effect of high-dose N-acetylcysteine on airway geometry, inflammation, and oxidative stress in COPD patients

De Backer J, Vos W, Van Holsbeke C, Vinchurkar S, Claes R, Parizel PM, De Backer W

International Journal of Chronic Obstructive Pulmonary Disease 2013, 8:569-579

Published Date: 22 November 2013

Home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized clinical trial

Dias FD, Sampaio LMM, da Silva GA, Dantas Gomes ELF, Nascimento ESP, Santos Alves VL, Stirbulov R, Costa D

International Journal of Chronic Obstructive Pulmonary Disease 2013, 8:537-544

Published Date: 5 November 2013

Efficacy of levofloxacin versus cefuroxime in treating acute exacerbations of chronic obstructive pulmonary disease

Yoon HI, Lee CH, Kim DK, Park GM, Lee SM, Yim JJ, Kim JY, Lee JH, Lee CT, Chung HS, Kim YW, Han SK, Yoo CG

International Journal of Chronic Obstructive Pulmonary Disease 2013, 8:329-334

Published Date: 10 July 2013