| Objective:To systematically analyze the accuracy of ECG,echocardiography and ECG combined with echocardiography in evaluating the severity of pulmonary hypertension,so as to provide practical experience for the judgment of the severity of pulmonary hypertension in the future.Methods:This is a multicenter,retrospective cohort study.Methods right heart catheterization was performed in the Affiliated Hospital of Qingdao University and Qilu Hospital of Shandong Uninersity from January 2017 to January 2021 According to p H diagnostic criteria,patients were divided into mild p H group(mPAP value range 26-35mmhg),moderate p H group(mPAP value range 36-45mmhg)and severe p H group(mPAP >45mmhg).Objective to analyze the correlation between the indexes of ECG and echocardiography and the severity of clinical symptoms in patients with pulmonary hypertension.Outcome measures: ECG outcome measures: heart rate,QT interval,QRS axis,R wave amplitude,time limit and vertex angle in lead a VR,P wave amplitude and time limit in leads II,III and AVF,R wave and S wave amplitude and time limit in leads I,II,V1,V5 and V6.Echocardiographic parameters: pulmonary artery systolic pressure(PASP),plane systolic excursion of tricuspid annulus(TAPSE),TAPSE / PASP and pericardial effusion.Statistical methods: spss25.0 statistical analysis software package was used for statistical processing,and the measurement data were tested for normal distribution and homogeneity of variance.The data conforming to normal distribution were expressed as mean ± standard deviation(x ± s),and the data of non normal distribution were expressed as median(P25,P75).The measurement data of normal distribution were compared by one-way ANOVA,and the measurement data of non normal distribution were analyzed by one-way ANOVA Rank sum test.Spearman correlation analysis was used to evaluate the correlation between echocardiography,ECG and RHC data;Receiver operating characteristic curve(ROC curve)to evaluate the sensitivity and specificity of echocardiography and electrocardiogram in evaluating the severity of pulmonary hypertension.Set P < 0.05 as the difference was statistically significant.Results:1.There was no significant difference in age,gender,systolic blood pressure,diastolic blood pressure,body weight,BMI,waist circumference,waist hip ratio among the three groups(P > 0.05).2.The proportion of who-fc III and who-fc IV in severe p H group was significantly higher than that in moderate p H group and mild p H group,and the difference was statistically significant(P < 0.05).3.There were significant differences in PASP,PADP,mPAP,RVSP and mrvp among the three groups(P < 0.05);4.There were significant differences in PASP,TAPSE,TAPSE / PASP and pericardial effusion among the three groups(P < 0.05);5.PASP,TAPSE,TAPSE / PASP and pericardial effusion ratio were positively correlated with mPAP(r = 0.687,0.711,0.801,0.441,respectively),and the difference was statistically significant(P < 0.05).6.There were significant differences in QT interval,sv1 amplitude,Rv5 amplitude,PII amplitude,PAVF amplitude,PAVF duration and PIII duration among the three groups(P < 0.05).7.QT interval,sv1 amplitude,Rv5 amplitude,PII amplitude,PAVF amplitude,PAVF duration and PIII duration were positively correlated with mPAP(r = 0.708,0.619,0.637,0.741,0.605,0.501,0.499,respectively),and the difference was statistically significant(P < 0.05).8.ROC curve showed that AUC of right heart catheterization was 0.97,P < 0.05;The AUC of QT interval was 0.672,P < 0.05;The AUC of TAPSE / PASP was 0.730,P< 0.05;The AUC of QT interval combined with TAPSE / PASP was 0.804,P < 0.05.Conclusions:1.Electrocardiogram QT interval has certain application value in the clinical diagnosis of pulmonary hypertension,but the sensitivity and specificity of evaluating the severity of pulmonary hypertension is not high;2.Compared with the QT interval of ECG,echocardiography TAPSE/PASP has higher sensitivity and specificity for assessing the severity of pulmonary hypertension;3.ECG QT interval combined with echocardiography TAPSE / PASP can effectively evaluate the severity of pulmonary hypertension with high specificity and sensitivity. |
