PMID- 30594338
OWN - NLM
STAT- MEDLINE
DCOM- 20200508
LR  - 20200508
IS  - 1876-4738 (Electronic)
IS  - 0914-5087 (Linking)
VI  - 73
IP  - 4
DP  - 2019 Apr
TI  - Characteristics of synthesized right-sided chest electrocardiograms in patients 
      with acute pulmonary embolism.
PG  - 313-317
LID - S0914-5087(18)30353-8 [pii]
LID - 10.1016/j.jjcc.2018.12.010 [doi]
AB  - BACKGROUND: The significance of right-sided chest lead electrocardiogram (ECG) 
      abnormalities in acute pulmonary embolism (APE) is unclear. This study evaluated 
      the characteristics of such abnormalities in APE patients. METHODS: This 
      retrospective study included consecutive patients who were diagnosed with APE by 
      contrast-enhanced computed tomography or pulmonary artery angiography. A standard 
      12-lead ECG and a synthesized right-sided chest ECG were obtained from these 
      patients. Waveform differences were noted between the acute and post-treatment 
      phases. RESULTS: In total, 56 APE patients (18 men and 38 women, mean age 
      66.7+/-13.3 years) were included. Traditional ECG findings, such as right-axis 
      deviation, the S(1)Q(3)T(3) pattern, and clockwise rotation, were found in 
      relatively few patients (14.3%, 32.1%, and 21.4%, respectively). In some cases, a 
      negative T wave in standard 12-lead ECGs was observed in leads III, V1, and V2 
      (46.4%, 60.7%, and 39.9%, respectively). Syn-V3R ECG showed a higher frequency of 
      negative T waves (66.1%) at the onset and significantly (p<0.01) decreased at the 
      follow-up. Multiple logistic regression analyses for differentiating APE revealed 
      that the negative T waves only in lead syn-V3R were significantly related (odds 
      ratio: 6.95, 95% confidence interval: 2.50-19.32, p<0.001). CONCLUSIONS: The 
      presence of a negative T wave in a synthesized right-sided chest ECG, 
      particularly in the V3R lead, is a new and distinctive finding denoting pulmonary 
      embolism. To confirm the utility of this characteristic using synthesized 
      right-sided chest ECGs for the diagnosis of APE, further studies with larger 
      populations will be required.
CI  - Copyright (c) 2018. Published by Elsevier Ltd.
FAU - Kusayama, Takashi
AU  - Kusayama T
AD  - Department of System Biology, Kanazawa University Graduate School of Advanced 
      Preventive Medical Sciences, Ishikawa, Japan.
FAU - Furusho, Hiroshi
AU  - Furusho H
AD  - Department of System Biology, Kanazawa University Graduate School of Advanced 
      Preventive Medical Sciences, Ishikawa, Japan. Electronic address: 
      hfurusho@m-kanazawa.jp.
FAU - Kinoshita, Masaki
AU  - Kinoshita M
AD  - Division of Cardiology, Department of Internal Medicine, Toyama Prefectural 
      Central Hospital, Toyama, Japan.
FAU - Kaneko, Shuichi
AU  - Kaneko S
AD  - Department of System Biology, Kanazawa University Graduate School of Advanced 
      Preventive Medical Sciences, Ishikawa, Japan.
FAU - Usuda, Kazuo
AU  - Usuda K
AD  - Division of Cardiology, Department of Internal Medicine, Toyama Prefectural 
      Central Hospital, Toyama, Japan.
FAU - Takamura, Masayuki
AU  - Takamura M
AD  - Department of System Biology, Kanazawa University Graduate School of Advanced 
      Preventive Medical Sciences, Ishikawa, Japan.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20181226
PL  - Netherlands
TA  - J Cardiol
JT  - Journal of cardiology
JID - 8804703
SB  - IM
MH  - Acute Disease
MH  - Aged
MH  - Arrhythmias, Cardiac/diagnostic imaging
MH  - Computed Tomography Angiography/methods
MH  - Electrocardiography/instrumentation/*methods
MH  - Female
MH  - Heart Conduction System/diagnostic imaging
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Pulmonary Artery/diagnostic imaging
MH  - Pulmonary Embolism/*diagnostic imaging
MH  - Retrospective Studies
MH  - Thorax/diagnostic imaging
MH  - Tomography, X-Ray Computed/methods
OTO - NOTNLM
OT  - Acute pulmonary embolism
OT  - Negative T wave
OT  - Right-sided chest lead
OT  - Synthesized electrocardiography
EDAT- 2018/12/31 06:00
MHDA- 2020/05/10 06:00
CRDT- 2018/12/31 06:00
PHST- 2018/07/13 00:00 [received]
PHST- 2018/10/08 00:00 [revised]
PHST- 2018/10/22 00:00 [accepted]
PHST- 2018/12/31 06:00 [pubmed]
PHST- 2020/05/10 06:00 [medline]
PHST- 2018/12/31 06:00 [entrez]
AID - S0914-5087(18)30353-8 [pii]
AID - 10.1016/j.jjcc.2018.12.010 [doi]
PST - ppublish
SO  - J Cardiol. 2019 Apr;73(4):313-317. doi: 10.1016/j.jjcc.2018.12.010. Epub 2018 Dec 
      26.