Work

Diagnostic value of a novel electrocardiographic score for acute pulmonary embolism: A prospective cohort study

Year: 2026

Type: article

Abstract: Objective: The novel electrocardiographic score (nECGs) may provide complementary diagnostic information for acute pulmonary embolism (PE), but evidence in Vietnamese patients remains limited.Objectives: To evaluate the diagnostic performance of nECGs compared with the Wells score and D-dimer thresholds for the detection of acute PE.Methods: This prospective single-center diagnostic accuracy study included 110 consecutive adult patients with suspected PE who underwent standard 12-lead ECG, right-sided ECG, and computed tomography pulmonary angiography (CTPA).Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis.CTPA served as the reference standard.Results: Acute PE was confirmed in 56/110 patients (50.9%; median age 70.5 years).The nECGs demonstrated a significantly higher AUC (0.798; 95% CI, 0.711-0.868)than the Wells score ≥ 4 (0.701; 95% CI, 0.68206-0.785)and age-adjusted D-dimer (0.593; 95% CI, 0.495-0.68286)(p<0.001).nECGs achieved 91.1% sensitivity and 68.5% specificity.Fixed D-dimer (> 500 ng/mL) showed 100% sensitivity but only 9.3% specificity.Among 61 CTPA-selected patients with a Wells score ≤2, 20 (32.8%) had confirmed PE.In this subgroup, nECGs showed good discriminatory power (AUC 0.828) with a LR+ of 3.6829 and an LR-of 0.13.Combining nECGs with age-adjusted D-dimer increased LR+ to 4.36, while discrimination remained similar (AUC, 0.827). Conclusions:The nECGs provides good diagnostic discrimination for acute PE in this selected tertiary-care population and retained its performance among CTPA-selected patients with a Wells score <2.It may provide complementary bedside information within established PE diagnostic pathways.External validation in larger, lower-prevalence populations is warranted.

Source: Heart Vessels and Transplantation

DOI: 10.24969/hvt.2026.682

Authors: Tung Minh Pham, Binh Thi Thanh Dao

Institution: HUTECH University

Language: English

Topic: Venous Thromboembolism Diagnosis and Management

Subfield: Internal Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $350