Diagnostic electrocardiographic dyad criteria of emphysema in left ventricular hypertrophy

International Journal of Chronic Obstructive Pulmonary Disease
Swapnil S LanjewarDavid H Spodick


The electrocardiographic diagnostic dyad of emphysema, namely a combination of the frontal vertical P-vector and a narrow QRS duration, can serve as a quasidiagnostic marker for emphysema, with specificity close to 100%. We postulated that the presence of left ventricular hypertrophy in emphysema may affect the sensitivity of this electrocardiographic criterion given that left ventricular hypertrophy generates prominent left ventricular forces and may increase the QRS duration. We reviewed the electrocardiograms and echocardiograms for 73 patients with emphysema. The patients were divided into two groups based on the presence or absence of echocardiographic evidence of left ventricular hypertrophy. The P-vector, QRS duration, and forced expiratory volume in one second (FEV1) were computed and compared between the two subgroups. There was no statistically significant difference in qualitative lung function (FEV1) between the subgroups. There was no statistically significant difference in mean P-vector between the subgroups. The mean QRS duration was significantly longer in patients with left ventricular hypertrophy as compared with those without left ventricular hypertrophy. The presence of left ventricular hypertrophy may not a...Continue Reading


Jan 1, 1974·The American Review of Respiratory Disease·W M ThurlbeckR G Frazer
Mar 20, 1999·Clinical Cardiology·R Baljepally, David H Spodick
Jul 27, 2000·The New England Journal of Medicine·P J Barnes
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May 22, 2013·International Journal of Chronic Obstructive Pulmonary Disease·Lovely ChhabraDavid H Spodick
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Aug 25, 2015·International Journal of Cardiology·N Gurukripa Kowlgi, Lovely Chhabra

Related Concepts

Electrocardiographic Recorders
Forced Expiratory Volume Function
Focal Emphysema
Tomography, Ultrasonic
Reproducibility of Results
Left Ventricular Hypertrophy
Biological Markers
Genetic Vectors

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