How Accurate can Electrocardiogram Predict Left Ventricular Diastolic Dysfunction?

Heart failure continues to be a major challenge to healthcare; several resting and exercise electrocardiographic parameters have been investigated to predict the left ventricular diastolic dysfunction (LVDD). One hundred and forty patients, classified into 2 groups according to LVDD, were assessed by measurement of normal and corrected QT interval, T wave peak to T wave End and P wave dispersion in resting ECG. Exercise stress test looking for Hump sign (upward deflection of the ST-segment) was done. The relationships between these ECG parameters and LVDD were investigated. The study revealed significant occurrence of hump sign in patients with LVDD, there was a significant difference between both groups regarding QTc and P wave dispersion. P wave dispersion was significantly higher in patients with LVDD. Sensitivity and specificity of the ST hump sign in prediction of LVDD were 86% and 78% respectively. The study also concluded that P wave dispersion at cut off value of about 0.045 msec had the highest sensitivity (sensitivity 98%; specificity 64%) while QTc at cut off value of 0.395 msec had the highest specificity (sensitivity 81%, specificity 79%). P wave dispersion and hump sign had higher sensitivity while corrected QT interval had higher specificity in prediction of LVDD.