Holt J H, Barnard A C, Kramer J O
Circulation. 1977 Sep;56(3):391-4. doi: 10.1161/01.cir.56.3.391.
This report concerns the task of electrocardiographic (ECG) diagnosis and quantitation of left ventricular hypertrophy (LVH) in patients with right bundle branch block (RBBB). In 36 patients with RBBB the left ventricular mass (LVM) of each patient was independently known from quantitative biplane angiography. Two ECG techniques, standard 12-lead ECG and multiple dipole electrocardiography (MDECG), were evaluated. In diagnosing LVH, the best performance of the several standard ECG criteria was sensitivity = 29%, specificity = 100%, and that of the MDECG was sensitivity = 94%, specificity = 96%. In quantitating LVH, the standard ECG gave a correlation with LVM of r = 46% and a standard error of estimate of 98 g. The corresponding figures for the MDECG were r = 81% and the root mean square prediction error = 64 g. These results confirm other studies showing that the conventional ECG is of only marginal value in the task of diagnosing LVH in the presence of RBBB. In contrast, the MDECG performs well both in this task and that of quantitating LVH. The results provide further support of the accuracy of the model of the cardiac electrical generator and volume conductor used in the MDECG method.
本报告涉及右束支传导阻滞（RBBB）患者的心电图（ECG）诊断及左心室肥厚（LVH）定量分析任务。36例RBBB患者的左心室质量（LVM）通过定量双平面血管造影术独立测得。对两种心电图技术，即标准12导联心电图和多偶极子心电图（MDECG）进行了评估。在诊断LVH时，几种标准心电图标准的最佳表现为：敏感性=29%，特异性=100%；而MDECG的敏感性=94%，特异性=96%。在LVH定量分析方面，标准心电图与LVM的相关性r=46%，估计标准误差为98克。MDECG的相应数据为r=81%，均方根预测误差=64克。这些结果证实了其他研究，表明传统心电图在RBBB患者LVH诊断任务中价值有限。相比之下，MDECG在该任务及LVH定量分析方面均表现良好。结果进一步支持了MDECG方法中所使用的心脏电发生器和容积导体模型的准确性。
