{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T17:42:13Z","timestamp":1767894133557,"version":"3.49.0"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T00:00:00Z","timestamp":1725840000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003970","name":"Isfahan University of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003970","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Right ventricular systolic dysfunction is associated with poor prognosis and increased mortality rates. Our objective was to investigate ECG changes in patients with this condition, focusing on the right\u2010sided precordial leads.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this cross\u2010sectional study, 60 patients with right ventricular dysfunction were included from April 2020 to April 2021. Cardiac structure and function were assessed using 2D transthoracic echocardiography. Standard 12\u2010lead electrocardiograms and right\u2010sided precordial ECGs (V3R\u2010V4R) were obtained and analyzed for QRS complex configuration, ST\u2010segment elevation, and T\u2010wave morphology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In our study, the majority were male (70.0%) with a mean age of 58.76\u2009years. The most common initial diagnoses were pulmonary thromboembolism (43.3%), chronic obstructive pulmonary disease (26.7%), and pulmonary hypertension (25.0%). The predominant ECG finding in the right\u2010sided precordial leads (V3R, V4R) was a deep negative T wave (90.0%). Patients with severe right ventricular systolic dysfunction often exhibited a qR pattern (41.2%), whereas those with nonsevere dysfunction showed rS and QS patterns (55.8%). Approximately 41.0% of severe RV dysfunction cases had ST segment depression in the right\u2010sided precordial leads, and 28.0% of patients displayed signs of right atrial abnormality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The study found that qR, rS, and QS patterns were more prevalent in V3R and V4R leads among patients with severe and nonsevere right ventricular systolic dysfunction. The most common ECG feature observed was deep T\u2010wave inversion in these leads. The study recommends using right\u2010sided precordial leads in all patients with RV systolic dysfunction for early detection and risk stratification.<\/jats:p><\/jats:sec>","DOI":"10.1111\/anec.70006","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T08:44:54Z","timestamp":1725871494000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Significance of Right\u2010Sided Precordial <scp>ECG<\/scp> Leads (<scp>V3R<\/scp> and <scp>V4R<\/scp>) in Assessing Right Ventricular Dysfunction: A\u00a0Single Center Cross\u2010Sectional Study"],"prefix":"10.1111","volume":"29","author":[{"given":"Reza","family":"Khosravi","sequence":"first","affiliation":[{"name":"Isfahan University of Medical Sciences  Isfahan Iran"},{"name":"Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center Iran University of Medical Sciences  Tehran 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