Evidence map›Paper›PMID 34784604›Full record

Observational studyRespiration; international review of thoracic diseases2022

Clinical Utility of the Electrocardiographic P-Wave Axis in Patients with Chronic Obstructive Pulmonary Disease.

Shiro Otake, Shotaro Chubachi, Shingo Nakayama, Kaori Sakurai, Hidehiro Irie, Mizuha Hashiguchi, Yuji Itabashi, Yoshitake Yamada, Masahiro Jinzaki, Mitsuru Murata and 3 more

Open access · hybridAbstract readObservational Study
In one paragraph

Observational study in Respiration; international review of thoracic diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 46% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 1 country.

Shiro OtakeDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Shotaro ChubachiDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Shingo NakayamaDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Kaori SakuraiDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Hidehiro IrieDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Mizuha HashiguchiDivision of Pulmonary Medicine, Department of Medicine, Keiyu Hospital, Yokohama, Japan.
Yuji ItabashiDepartment of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan.
Yoshitake YamadaDepartment of Radiology, Keio University School of Medicine, Tokyo, Japan.
Masahiro JinzakiDepartment of Radiology, Keio University School of Medicine, Tokyo, Japan.
Mitsuru MurataDepartment of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan.
Hidetoshi NakamuraDivision of Pulmonary Medicine, Saitama Medical University Hospital, Saitama, Japan.
Koichiro AsanoDivision of Pulmonary Medicine, Department of Medicine, Tokai University, School of Medicine, Kanagawa, Japan.
Koichi FukunagaDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Keio University · JPkeiyu Hospital · JPSaitama Medical University Hospital · JPTokai University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe vertical P-wave axis on electrocardiography (ECG) is a useful criterion for screening patients with chronic obstructive pulmonary disease (COPD). This study aimed to investigate the clinical characteristics of patients with COPD with a vertical P-wave axis as they have not yet been elucidated.

methodsKeio University and its affiliated hospitals conducted an observational COPD cohort study over 3 years. We analyzed 201 patients using ECG and chest computed tomography.

resultsThe severity of airflow limitation was higher in patients with a P-wave axis >75° than in those with a P-wave axis ≤75°. Patients with a P-wave axis >75° exhibited significantly higher total COPD assessment test scores and increased St. George's Respiratory Questionnaire total, activity, and impact scores than those with a P-wave axis ≤75°. The incidence of exacerbations over 1 and 3 years was significantly higher in patients with a P-wave axis >75° than in those with a P-wave axis ≤75°. The optimal cutoff for the P-wave axis for a percentage of the predicted forced expiratory volume in 1 s <50% and future exacerbations over 3 years was 70° (the areas under the curve [AUC]: 0.788; sensitivity: 65.3%; specificity: 78.3%) and 79° (AUC: 0.642; sensitivity: 36.7%; specificity: 92.6%). The ratio of the low attenuation area was also significantly higher in patients with a P-wave axis >75° than in those with a P-wave axis ≤75°. However, the ratio of the airway wall area did not differ between the 2 groups.

conclusionsPatients with COPD with a vertical P-wave axis exhibited severe airflow limitation and emphysema, a worse health status, and more frequent exacerbation than patients without a vertical P-wave. Detection of the vertical P-wave axis by ECG is beneficial for the management of patients with COPD.

Indexed as

Pulmonary Disease, Chronic ObstructivePulmonary EmphysemaCohort StudiesElectrocardiographyForced Expiratory VolumeHumansChronic obstructive pulmonary diseaseElectrocardiographyEmphysemaP-wave axisQRS-wave axis

Identifiers

PMID34784604
PMCPMC9153333
OpenAlexW3214146996

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.