| 류현민, 이상혁, 배명환, 이장훈, 양동헌, 박헌식, 조용근, 채성철, 전재은, 박의현 |
Background: ECG is considered as a simple and economical tool for diagnosing acute pulmonary embolism (PE) due to its association with various ECG abnormalities. ECG score was indicated because data on usefulness of composition of each ECG abnormalities predicting the severity of acute PE is still lacking. The aim of this study was to assess 12-lead ECG patterns in acute PE and to evaluate usefulness of ECG score in the prediction of the severity of patients with acute PE. Methods: One hundred twenty-five consecutive patients (63±14 years, 56 men) with acute PE who visited Kyungpook National University Hospital between November 2001 and January 2008 were included. We calculated ECG score based on ECG findings and measured right ventricular systolic pressure (RVSP) (n=75) and investigated the presence of RV hypokinesia (n=80) in available patients for assessing the severity of acute PE. Results: Among several ECG findings, sinus tachycardia and inverted T wave in V1-4 (39%) were observed the most frequently. S1Q3T3 (27%) was observed the next frequently. Mean ECG score and RVSP were 7.36±6.32 and 49±21 mmHg, respectively. ECG score correlated with RVSP (r=0.277, p=0.016). The patients were divided into two groups (high ECG score group (n=38); ECG score >12, low ECG score group (n=87); ECG score ≤12) based on ECG score having the maximal area under the curve. Mean RVSP was more significantly higher and RV hypokinesia was observed more frequently in high ECG score group than low ECG score group (56.4±20.2 mmHg vs. 42.9±20.0 mmHg, p=0.005; 77% vs. 47%, p=0.006, respectively). Multivariate analysis revealed that high ECG score was an independent predictor of higher RVSP (odds ratio (OR)=8.264, 95% confidence interval (CI)=2.053-33.333, p=0.003) as well as RV hypokinesia (OR=8.389, 95% CI=1.923-36.602, p=0.005). Conclusions: Sinus tachycardia, precordial inverted T wave and S1Q3T3 were commonly observed in patients with acute PE. Moreover, ECG score is a useful, simple, and economical tool predicting the severity of patients with acute PE.
|
