Evaluating the diagnostic value of the Nehb lead in hypertension cases with left atrial enlargement
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective: To find the alterations in various parameter values of the Nehb lead in electrocardiogram (ECG) among patients with hypertension and atrial enlargement (LAE), and to explore the diagnostic value of Nehb lead in such patients, providing a more accurate diagnostic method for clinical use. Methods: Ninety in‐ and outpatients were included and divided into hypertension with LAE group and the healthy group (control group) based on certain diagnostic criteria. The morphology, amplitude, duration, and P /P-R ratio of their P-waves were statistically evaluated, respectively. Logistic analysis was used to explore the correlation between ECG P-wave parameters and LAE in patients. Results: The amplitude and duration of the P-wave in the D and A leads (Nehb lead) were both significantly higher than those in the traditional II lead ( P <0.05). The detection rate of atrial P-wave changes using the Nehb lead was ~93.2%, which was significantly higher than the rate of conventional 12-lead. No significant statistical difference in the P /P-R ratio was observed between the groups ( P >0.05). Logistic regression analysis revealed that the difference in P-wave amplitude between the A-II and D-II leads was a relevant factor for LAE ( P <0.05). ROC curve analysis indicated that the AUC values for evaluating LAE were 0.915 for the difference in P-wave amplitude between D-II and A-II leads, 0.769 for the Ptf-V1, and 0.563 for the conventional 12-lead ECG. Conclusions: The P-wave changes in the patients with LAE can be better detected using the Nehb lead. The difference in P-wave amplitude between leads is a relevant factor for the disease and demonstrates superior diagnostic efficacy compared with conventional ECG leads and the classic Ptf-V1.
Authors: Xianchun Ling, Peifen Chang
Language: English
Topic: ECG Monitoring and Analysis
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7127899506