Dolgin M, Fisher V J, Shah A, Fisher B
Am J Med Sci. 1977 May-Jun;273(3):301-7.
The 12-lead scalar electrocardiogram has been correlated with angiographically determined left ventricular dimensions in 103 consecutive patients in order to determine the reliability of the electrocardiographic diagnosis of left ventricular hypertrophy. Simple and multiple correlations between various parameters of QRS complex voltage and left ventricular mass, volume and wall thickness were poor but statistically significant. Mean voltage of QRS complex parameters was higher in patients with increased left ventricular mass and volume than in those with normal mass and volume, but the sensitivity of individual voltage parameters in identifying increased mass and volume was poor. A negative T wave in lead l or V6 was the most sensitive indicator of increased left ventricular mass and volume, but the specificity of this variable was poor. The sensitivity of "high voltage" of the QRS complex was increased (67 percent true positives) when moderate to marked increase in left ventricular mass had occurred, but at the expense of decreased specificity (13 percent false positives). It is concluded that while an increase in left ventricular dimensions tends to be associated with an increase in QRS voltage and a repolarization abnormality, the currently used electrocardiographic criteria for the diagnosis of left ventricular hypertrophy are both insensitive and nonspecific.
为了确定心电图诊断左心室肥厚的可靠性，对103例连续患者的12导联标量心电图与血管造影测定的左心室大小进行了相关性研究。QRS波群电压的各种参数与左心室质量、容积和壁厚之间的简单和多重相关性较差，但具有统计学意义。左心室质量和容积增加的患者QRS波群参数的平均电压高于质量和容积正常的患者，但个体电压参数识别质量和容积增加的敏感性较差。Ⅰ导联或V6导联的T波倒置是左心室质量和容积增加的最敏感指标，但该变量的特异性较差。当左心室质量出现中度至明显增加时，QRS波群“高电压”的敏感性增加（真阳性率为67%），但特异性降低（假阳性率为13%）。结论是，虽然左心室大小的增加往往与QRS电压的增加和复极异常有关，但目前用于诊断左心室肥厚的心电图标准既不敏感也不特异。
