{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:17:28Z","timestamp":1793330248546,"version":"4.5.0"},"reference-count":58,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T00:00:00Z","timestamp":1734048000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Deutsche Forschungsgemeinschaft (DFG)","award":["CP01"],"award-info":[{"award-number":["CP01"]}]},{"name":"Collaborative Research Center (CRC) 1213","award":["CP01"],"award-info":[{"award-number":["CP01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Pulmonary hypertension (PH) can cause characteristic electrocardiographic (ECG) changes due to right ventricular hypertrophy and\/or strain. The aims of the present study were to explore the diagnostic accuracy of ECG parameters for the diagnosis of PH, applying the recently adjusted mean pulmonary artery pressure (mPAP) threshold of &gt;20 mmHg, and to determine the role of \u201cR V1, V2 + S I, aVL \u2212 S V1\u201d. Methods: Between July 2012 and November 2023, 100 patients without PH, with pulmonary arterial hypertension, or with chronic thromboembolic pulmonary hypertension were retrospectively enrolled. Results: The sensitivity and specificity of the ECG parameters for the diagnosis of PH varied from 3 to 98% and from 3 to 100% (means: 39% and 87%). After optimising the parameters\u2019 cut-offs, the mean sensitivity (39% to 66%) increased significantly but the mean specificity (87% to 74%) slightly decreased. \u201cR V1, V2 + S I, aVL \u2212 S V1\u201d was able to predict an mPAP &gt;20 mmHg (OR: 34.33; p &lt; 0.001) and a pulmonary vascular resistance &gt;5 WU (OR: 17.14, p &lt; 0.001) but could not predict all-cause mortality. Conclusions: Even with improved cut-offs, ECG parameters alone are not able to reliably diagnose or exclude PH because of their low sensitivity. However, they still might be helpful to reveal a suspicion of PH, especially in early diagnostic stages, e.g., in primary care with general practitioners or non-specialised cardiologists and pulmonologists. \u201cR V1, V2 + S I, aVL \u2212 S V1\u201d was able to predict the diagnosis of (severe) PH but could not predict all-cause mortality. Nevertheless, it can still be useful in risk stratification.<\/jats:p>","DOI":"10.3390\/jcm13247613","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T10:34:12Z","timestamp":1734086052000},"page":"7613","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Diagnostic Accuracy of an Electrocardiogram in Pulmonary Hypertension and the Role of \u201cR V1, V2 + S I, aVL \u2212 S V1\u201d"],"prefix":"10.3390","volume":"13","author":[{"given":"Lukas","family":"Ley","sequence":"first","affiliation":[{"name":"Campus Kerckhoff, Justus Liebig University Giessen, 61231 Bad Nauheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph B.","family":"Wiedenroth","sequence":"additional","affiliation":[{"name":"Kerckhoff Heart and Thorax Center, Department of Thoracic Surgery, 61231 Bad Nauheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2238-9574","authenticated-orcid":false,"given":"Stefan","family":"Guth","sequence":"additional","affiliation":[{"name":"Kerckhoff Heart and Thorax Center, Department of Thoracic Surgery, 61231 Bad Nauheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Gold","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9505-8608","authenticated-orcid":false,"given":"Athiththan","family":"Yogeswaran","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), 35392 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossein Ardeschir","family":"Ghofrani","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), 35392 Giessen, Germany"},{"name":"Kerckhoff Heart and Thorax Center, Department of Pneumology, 61231 Bad Nauheim, Germany"},{"name":"Department of Medicine, Imperial College London, London SW7 2AZ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5341-5195","authenticated-orcid":false,"given":"Dirk","family":"Bandorski","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Semmelweis University Campus Hamburg, 20099 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3618","DOI":"10.1093\/eurheartj\/ehac237","article-title":"2022 ESC\/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension","volume":"43","author":"Humbert","year":"2022","journal-title":"Eur. 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