Observational studyEchocardiography (Mount Kisco, N.Y.)2026
Machine-Reported Electrocardiographic Right Axis Deviation or Right Ventricular Hypertrophy and Echocardiographic Pulmonary Hypertension Phenotypes and Right-Heart Abnormalities.
Observational study in Echocardiography (Mount Kisco, N.Y.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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Who cites it
3 citing papers in PubMed.
- The Electrocardiogram and Pulmonary Hypertension: When Occam'S Razor Fails.Echocardiography (Mount Kisco, N.Y.) · 2026Article
- Reply to "From Association to Action: Clarifying the Incremental Value of Machine-Reported RAD/RVH".Echocardiography (Mount Kisco, N.Y.) · 2026Article
- From Association to Action: Clarifying the Incremental Value of Machine-Reported RAD/RVH.Echocardiography (Mount Kisco, N.Y.) · 2026Article
Corrections and comments
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Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMachine-reported electrocardiographic findings suggesting right-heart strain are routinely generated during electrocardiogram (ECG) acquisition, but their relationship to echocardiographic pulmonary hypertension phenotypes and right-heart abnormalities remains incompletely defined. This study evaluated whether machine-reported right axis deviation (RAD) or right ventricular hypertrophy (RVH) is associated with echocardiographic pulmonary hypertension phenotypes and right-heart abnormalities in hospitalized patients.
methodsThis retrospective observational study used linked MIMIC-IV-ECG and MIMIC-IV-ECHO data. Echocardiograms were linked to the closest ECG obtained from 7 days before echocardiography through the time of echocardiography. The primary exposure was machine-reported RAD or RVH. The primary outcome was Echo-PH specific, a composite echo-derived phenotype including tricuspid regurgitation velocity greater than 3.4 m/s, moderate or severe pulmonary hypertension text, or right ventricular pressure overload. Logistic regression adjusted for demographics, comorbidities, and ICU status, with patient-level cluster-robust standard errors.
resultsThe cohort included 68 905 ECG-echocardiography pairs from 42 078 patients; 2815 pairs were RAD/RVH-positive. For Echo-PH specific, RAD/RVH had sensitivity 7.5%, specificity 96.7%, positive predictive value 35.5%, and negative predictive value 81.4%. RAD/RVH remained associated with Echo-PH specific after full adjustment using cluster-robust standard errors (odds ratio, 2.04; 95% confidence interval, 1.84-2.26). The adjusted probability of Echo-PH specific was 18.8% without RAD/RVH and 30.0% with RAD/RVH.
conclusionMachine-reported ECG RAD/RVH was highly specific but insensitive for echocardiographic pulmonary hypertension phenotypes and right-heart abnormalities. These routine ECG findings may serve as supportive clues to echocardiographic right-heart disease but should not be used to exclude it.
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