PMID- 22113752
OWN - NLM
STAT- MEDLINE
DCOM- 20120427
LR  - 20191112
IS  - 1898-018X (Electronic)
IS  - 1898-018X (Linking)
VI  - 18
IP  - 6
DP  - 2011
TI  - Electrocardiography and prognosis of patients with acute pulmonary embolism.
PG  - 648-53
AB  - BACKGROUND: To assess the influence of electrocardiographic (ECG) pattern on 
      prognosis and complications of patients hospitalized with acute pulmonary 
      embolism (APE). METHODS: We performed a retrospective analysis of 292 patients 
      who had confirmed APE. There were 183 females and 109 males, the age range was 17 
      to 89 years, and the mean age was 65.4 +/- 15.5 years. RESULTS: In our study group, 
      there were 33 deaths (mortality rate, 11.3%), and 73 (25%) patients developed 
      complications during hospitalization. Based on European Society of Cardiology 
      risk stratification, we classified 75 (25.7%) patients as high risk, 163 (55.8%) 
      patients as intermediate risk, and 54 (18.5%) patients as low risk. A comparison 
      between patients with complicated APE and those with no complications during 
      hospitalization indicated that the following ECG parameters were more common in 
      patients who had complications: atrial fibrillation, S1Q3T3 sign, negative T 
      waves in leads V2-V4, ST segment depression in leads V4-V6, ST segment elevation 
      in leads III, V1 and aVR, qR in lead V1, complete right bundle branch block 
      (RBBB), greater number of leads with negative T waves, and greater sum of the 
      amplitude of negative T waves. In multivariate analysis, the sum of negative T 
      waves (OR 0.88; p = 0.22), number of leads with negative T waves (OR 1.46; p = 
      0.001), RBBB (OR 2.87; p = 0.02) and ST segment elevation in leads V1 (OR 3.99; p 
      = 0.00017) and aVR (OR 2.49; p = 0.011) were independent predictors of 
      complications during hospitalization. In turn, in multivariate analysis, only the 
      sum of negative T waves (OR 0.81; p = 0.0098), number of leads with negative T 
      waves [OR 1.68; p = 0.00068] and ST segment elevation in lead V1 (OR 4.47; p = 
      0.0003) were independent predictors of death during hospitalization. CONCLUSIONS: 
      In our population of APE patients, the sum of negative T waves, the number of 
      leads with negative T waves and the ST segment elevation in lead V1 were 
      independent predictors of death during hospitalization. In turn, the sum of 
      negative T waves, the number of leads with negative T waves, and RBBB and ST 
      segment elevation in leads V1 and aVR were independent predictors of 
      complications during hospitalization. We conclude that ECG analysis may be a 
      useful noninvasive method for risk stratification of patients with APE.
FAU - Kukla, Piotr
AU  - Kukla P
AD  - Department of Internal Diseases and Cardiology, H. Klimontowicz Hospital, 
      Gorlice, Poland. kukla_piotr@poczta.onet.pl
FAU - Dlugopolski, Robert
AU  - Dlugopolski R
FAU - Krupa, Ewa
AU  - Krupa E
FAU - Furtak, Romana
AU  - Furtak R
FAU - Szelemej, Roman
AU  - Szelemej R
FAU - Mirek-Bryniarska, Ewa
AU  - Mirek-Bryniarska E
FAU - Jastrzebski, Marek
AU  - Jastrzebski M
FAU - Nowak, Jacek
AU  - Nowak J
FAU - Wanczura, Piotr
AU  - Wanczura P
FAU - Bryniarski, Leszek
AU  - Bryniarski L
LA  - eng
PT  - Journal Article
PL  - Poland
TA  - Cardiol J
JT  - Cardiology journal
JID - 101392712
SB  - IM
MH  - Acute Disease
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Chi-Square Distribution
MH  - *Electrocardiography
MH  - Female
MH  - Hospital Mortality
MH  - Hospitalization
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Poland
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Pulmonary Embolism/complications/*diagnosis/mortality
MH  - Registries
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Young Adult
EDAT- 2011/11/25 06:00
MHDA- 2012/04/28 06:00
CRDT- 2011/11/25 06:00
PHST- 2011/11/25 06:00 [entrez]
PHST- 2011/11/25 06:00 [pubmed]
PHST- 2012/04/28 06:00 [medline]
AID - 10.5603/cj.2011.0028 [doi]
PST - ppublish
SO  - Cardiol J. 2011;18(6):648-53. doi: 10.5603/cj.2011.0028.