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Assessment of Clinical Usefulness of Resting Electrocardiogram (PH-ECG Score) in Monitoring the Efficacy of Balloon Pulmonary Angioplasty (BPA) in Patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH)

Background: Balloon pulmonary angioplasty (BPA) is a form of therapy for chronic thromboembolic pulmonary hypertension (CTEPH). The study objective is to assess the clinical usefulness of resting ECG (PH-ECG score) in monitoring the efficacy of BPA in CTEPH patients. Methods and results: Ninety-four...

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Autores principales: Piłka, Michał, Mańczak, Małgorzata, Darocha, Szymon, Banaszkiewicz, Marta, Mańczak, Rafał, Florczyk, Michał, Kędzierski, Piotr, Pietrasik, Arkadiusz, Balsam, Paweł, Kurzyna, Paweł, Wasilewski, Marcin, Wolański, Rafał, Torbicki, Adam, Kurzyna, Marcin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509271/
https://www.ncbi.nlm.nih.gov/pubmed/34640565
http://dx.doi.org/10.3390/jcm10194548
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author Piłka, Michał
Mańczak, Małgorzata
Darocha, Szymon
Banaszkiewicz, Marta
Mańczak, Rafał
Florczyk, Michał
Kędzierski, Piotr
Pietrasik, Arkadiusz
Balsam, Paweł
Kurzyna, Paweł
Wasilewski, Marcin
Wolański, Rafał
Torbicki, Adam
Kurzyna, Marcin
author_facet Piłka, Michał
Mańczak, Małgorzata
Darocha, Szymon
Banaszkiewicz, Marta
Mańczak, Rafał
Florczyk, Michał
Kędzierski, Piotr
Pietrasik, Arkadiusz
Balsam, Paweł
Kurzyna, Paweł
Wasilewski, Marcin
Wolański, Rafał
Torbicki, Adam
Kurzyna, Marcin
author_sort Piłka, Michał
collection PubMed
description Background: Balloon pulmonary angioplasty (BPA) is a form of therapy for chronic thromboembolic pulmonary hypertension (CTEPH). The study objective is to assess the clinical usefulness of resting ECG (PH-ECG score) in monitoring the efficacy of BPA in CTEPH patients. Methods and results: Ninety-four (n = 94) CTEPH patients were included in the analysis. A standard 12-lead-ECG was performed before the first BPA session and after completion of treatment. The whole analysed population (n = 94) was divided into the following two groups: derivation cohort (n = 41) and validation cohort (n = 53). The derivation cohort was divided into the following two subgroups: patients with mean pulmonary artery pressure (mPAP) after the completion of therapy < 25 mmHg (n = 21) and patients with mPAP after the completion of therapy ≥ 25 mmHg (n = 20). In the first subgroup, four (R-wave V1 + S-wave V5/V6 > 10.5 mm, QRS-wave axis > 110 degrees, R-wave V1 > S-wave V1, SIQIII pattern) of the six ECG parameters of overload of the right cardiac chambers showed statistically significant differences (p < 0.005). That was followed by a determination of the sensitivity and specificity, positive (PPV) and negative predictive value (NPV), and ROC curve (AUC 0.9; 95% CI: 0.792–1.000) for the variable that was a sum of the above four ECG parameters (PH-ECG score). The absence of all of the four ECG parameters at rest (PH-ECG score = 0) well reflected patients with mPAP < 25 mmHg (sensitivity, 100%; specificity, 80%; PPV, 84%; NPV, 100%). In the validation cohort with mPAP < 25 mmHg and PH-ECG score = 0, sensitivity, specificity, PPV, and NPV were 86%, 77%, 73%, and 89%, respectively. Conclusions: Resting ECG trace is clinically useful in the monitoring of therapeutical effects of BPA in CTEPH patients.
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spelling pubmed-85092712021-10-13 Assessment of Clinical Usefulness of Resting Electrocardiogram (PH-ECG Score) in Monitoring the Efficacy of Balloon Pulmonary Angioplasty (BPA) in Patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Piłka, Michał Mańczak, Małgorzata Darocha, Szymon Banaszkiewicz, Marta Mańczak, Rafał Florczyk, Michał Kędzierski, Piotr Pietrasik, Arkadiusz Balsam, Paweł Kurzyna, Paweł Wasilewski, Marcin Wolański, Rafał Torbicki, Adam Kurzyna, Marcin J Clin Med Article Background: Balloon pulmonary angioplasty (BPA) is a form of therapy for chronic thromboembolic pulmonary hypertension (CTEPH). The study objective is to assess the clinical usefulness of resting ECG (PH-ECG score) in monitoring the efficacy of BPA in CTEPH patients. Methods and results: Ninety-four (n = 94) CTEPH patients were included in the analysis. A standard 12-lead-ECG was performed before the first BPA session and after completion of treatment. The whole analysed population (n = 94) was divided into the following two groups: derivation cohort (n = 41) and validation cohort (n = 53). The derivation cohort was divided into the following two subgroups: patients with mean pulmonary artery pressure (mPAP) after the completion of therapy < 25 mmHg (n = 21) and patients with mPAP after the completion of therapy ≥ 25 mmHg (n = 20). In the first subgroup, four (R-wave V1 + S-wave V5/V6 > 10.5 mm, QRS-wave axis > 110 degrees, R-wave V1 > S-wave V1, SIQIII pattern) of the six ECG parameters of overload of the right cardiac chambers showed statistically significant differences (p < 0.005). That was followed by a determination of the sensitivity and specificity, positive (PPV) and negative predictive value (NPV), and ROC curve (AUC 0.9; 95% CI: 0.792–1.000) for the variable that was a sum of the above four ECG parameters (PH-ECG score). The absence of all of the four ECG parameters at rest (PH-ECG score = 0) well reflected patients with mPAP < 25 mmHg (sensitivity, 100%; specificity, 80%; PPV, 84%; NPV, 100%). In the validation cohort with mPAP < 25 mmHg and PH-ECG score = 0, sensitivity, specificity, PPV, and NPV were 86%, 77%, 73%, and 89%, respectively. Conclusions: Resting ECG trace is clinically useful in the monitoring of therapeutical effects of BPA in CTEPH patients. MDPI 2021-09-30 /pmc/articles/PMC8509271/ /pubmed/34640565 http://dx.doi.org/10.3390/jcm10194548 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Piłka, Michał
Mańczak, Małgorzata
Darocha, Szymon
Banaszkiewicz, Marta
Mańczak, Rafał
Florczyk, Michał
Kędzierski, Piotr
Pietrasik, Arkadiusz
Balsam, Paweł
Kurzyna, Paweł
Wasilewski, Marcin
Wolański, Rafał
Torbicki, Adam
Kurzyna, Marcin
Assessment of Clinical Usefulness of Resting Electrocardiogram (PH-ECG Score) in Monitoring the Efficacy of Balloon Pulmonary Angioplasty (BPA) in Patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH)
title Assessment of Clinical Usefulness of Resting Electrocardiogram (PH-ECG Score) in Monitoring the Efficacy of Balloon Pulmonary Angioplasty (BPA) in Patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH)
title_full Assessment of Clinical Usefulness of Resting Electrocardiogram (PH-ECG Score) in Monitoring the Efficacy of Balloon Pulmonary Angioplasty (BPA) in Patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH)
title_fullStr Assessment of Clinical Usefulness of Resting Electrocardiogram (PH-ECG Score) in Monitoring the Efficacy of Balloon Pulmonary Angioplasty (BPA) in Patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH)
title_full_unstemmed Assessment of Clinical Usefulness of Resting Electrocardiogram (PH-ECG Score) in Monitoring the Efficacy of Balloon Pulmonary Angioplasty (BPA) in Patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH)
title_short Assessment of Clinical Usefulness of Resting Electrocardiogram (PH-ECG Score) in Monitoring the Efficacy of Balloon Pulmonary Angioplasty (BPA) in Patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH)
title_sort assessment of clinical usefulness of resting electrocardiogram (ph-ecg score) in monitoring the efficacy of balloon pulmonary angioplasty (bpa) in patients with chronic thromboembolic pulmonary hypertension (cteph)
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509271/
https://www.ncbi.nlm.nih.gov/pubmed/34640565
http://dx.doi.org/10.3390/jcm10194548
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