Home Bratislava Medical Journal 2018 Bratislava Medical Journal Vol.119, No.6, p.321-329, 2018

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Published Monthly, in English
Founded: 1919
ISSN 0006-9248
(E)ISSN 1336-0345

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Bratislava Medical Journal Vol.119, No.6, p.321-329, 2018

Title: Eisenmenger syndrome – an electrocardiographic and echocardiographic assessment of the right ventricle
Author: T. Valkovicova, M. Kaldararova, A. Reptova, M. Bohacekova, L. Bacharova, R. Hatala, I. Simkova

Abstract: BACKGROUND: Eisenmenger syndrome represents severe, irreversible, and end-stage pulmonary arterial hypertension (PAH) associated with congenital heart defects. For long-term outcome optimal right ventricular (RV) adaptation is crucial with precise assessment of its hypertrophy, dilatation and function.
Objectives: Associations of electrocardiographic (ECG) and echocardiographic (ECHO) RV characteristics were analyzed.
METHODS: Included were 52 patients (39F/13M), median age 45 years (24–78). Following ECG parameters were analyzed: Butler–Leggett formula (B-L), Sokolow–Lyon criterion (S-L), QRS duration (QRS), maximum spatial QRS vector magnitude (QRS max); and ECHO parameters: RV diameter (RVd), RV wall thickness (RVAW), RV/LV function.
RESULTS: Following significant ECG-ECHO associations were demonstrated: S-L criterion and B-L formula with RVAW (p 120 ms only with severely dilated RV (RVd > 45 mm), while QRS max 33 mm); A new combined scoring system was introduced.
CONCLUSIONS: In Eisenmenger syndrome RV hypertrophy is compensatory; diagnosis of prognostically unfavorable RV dilatation is therefore important. Combined ECG-ECHO analysis enables more accurate risk stratification. QRS duration > 120 ms seems to be a late marker; QRS max together with ECHO parameters may help to distinguish patients at higher risk for clinical deterioration (Tab. 3, Fig. 8, Ref. 53).

Keywords: congenital heart defects, pulmonary arterial hypertension, right ventricular hypertrophy, right ventricular dilatation, electrocardiography, echocardiography
Published online: 27-Jun-2018
Year: 2018, Volume: 119, Issue: 6 Page From: 321, Page To: 329
doi:10.4149/BLL_2018_060


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