Electrocardiogram as prognostic and diagnostic parameter in follow up of patients with heart failure

Introduction: Most patients with HF due to systolic dysfunction have a significant abnormality on ECG. It is a widely available tool relatively inexpensive, simple to perform, and yields an instant result. Aim: To determine whether heart failure (ECG) conveys prognostic and diagnostic information in patients with HF. Methods: The study was carried out on 100 heart failure patients. All patients were subjected to history taking, clinical examination, standard 12 lead ECG (at admission, discharge, and 3 month follow up) for assessment of the following: (QRS voltage amplitude: in limb leads and in chest leads, total QRS voltage and transthoracic echocardiography were done for all patients (at discharge and at 3 month follow up (FU). Results: There were 75males and 25 females, aged between 21 and 86 years (mean=59.14±13.41 - years). Total QRS voltage, limb leads voltage and chest leads voltage; all significantly increased from admission values (98.54±20.64, 37.87±11.06, and 60.67±15.26 mm) to (110.72±21.28, 43.01±11.92, and 67.71±15.22) at discharge (p 0.001 for all). Also there was a significant increase in voltage at FU (111.72±21.28, 43.30±11.96, and 68.61± 16.61 mm) (p 0.001 for all). There was a negative correlation found between left ventricular end diastolic and systolic dimensions (LVEDD and LVESD) with total QRS voltage, chest leads voltage and limb leads voltage, both at discharge and at FU. The total QRS Voltage was significantly higher in patients having no lower limb (LL) edema than those with edema on admission, at discharge and on FU (p 0.001). Conclusion: Voltages of ECG are considered one of the most important parameters in diagnosis and FU of patients with heart failure. Voltage of chest leads well correlated with LVEDD and LVESD. Voltage of limb leads has important inverse correlation with LL edema.