Evaluating the diagnostic value of the Nehb lead in hypertension cases with left atrial enlargement

Objective: To investigate the alterations in various parameter values of the Nehb lead in electrocardiogram (ECG) among patients with hypertension complicated by left atrial enlargement (LAE), and to explore the diagnostic value of the Nehb lead in such patients, aiming to provide a more accurate method for clinical diagnosis. Method: Ninety inpatients and outpatients were included and divided into the hypertension with LAE group (hypertension group) and the healthy control group based on the diagnostic criteria. The morphology, amplitude, duration, and P /P-R ratio of their P-waves were statistically evaluated respectively. Logistic regression analysis was employed to explore the correlation between the aforementioned ECG P-wave parameters and LAE in patients. Results: The amplitude and duration of the P-wave in the D and A leads of the 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 approximately 93.2%, which was significantly higher than the diagnostic yield of the conventional 12-lead ECG. No significant statistical difference in the P /P-R ratio was observed between 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 Ptf-V1, and 0.563 for the conventional 12-lead ECG. Conclusion: 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 to conventional ECG leads and the classic Ptf-V1.