使用手持式超声心动图对高血压患者进行左心室肥厚的社区筛查。

Community screening for left ventricular hypertrophy in patients with hypertension using hand-held echocardiography.

作者信息

Senior Roxy, Galasko Gavin, Hickman Michael, Jeetley Paramjit, Lahiri Avijit

机构信息

Department of Cardiovascular Medicine, Northwick Park Hospital, Watford Rd, Harrow, Middlesex, HAI 3UJ United Kingdom.

出版信息

J Am Soc Echocardiogr. 2004 Jan;17(1):56-61. doi: 10.1016/j.echo.2003.09.013.

DOI:10.1016/j.echo.2003.09.013

PMID:14712188

Abstract

Left ventricular (LV) hypertrophy (LVH) confers increased cardiovascular risk on patients with hypertension. Echocardiography using new hand-held devices might allow community-based cost-effective screening for LVH in a targeted hypertensive population. Thus, the aim of this study was to test the validity of hand-held ultrasound devices to screen for LVH in the community. Accordingly, 189 patients with hypertension attending a community-based heart failure screening program underwent echocardiography by both hand-held and standard devices by an experienced echocardiographer. LVH was defined as LV mass index >/=134 g.m(-2) for men and >/=110 g.m(-2) for women using the Devereux-modified American Society of Echocardiography cube equation. No significant differences were noted between the 2 devices in the measurement of LV wall thickness or LV mass index. Agreement for estimation of LVH between the 2 devices was 86% (kappa = 0.63). The sensitivity, specificity, and positive and negative predictive values of the hand-held device for predicting LVH were 72%, 91%, 73%, and 90%, respectively. Thus, hand-held echocardiography devices accurately assessed LVH and may be used for community-based screening for LVH in targeted patients with hypertension.

摘要

左心室（LV）肥厚（LVH）会增加高血压患者的心血管疾病风险。使用新型手持设备进行超声心动图检查，可能会在目标高血压人群中实现基于社区的、具有成本效益的LVH筛查。因此，本研究的目的是检验手持超声设备在社区中筛查LVH的有效性。相应地，189名参加基于社区的心力衰竭筛查项目的高血压患者，由一位经验丰富的超声心动图医生使用手持设备和标准设备分别进行了超声心动图检查。使用Devereux修改后的美国超声心动图学会立方方程，将LVH定义为男性左心室质量指数≥134 g·m⁻²，女性≥110 g·m⁻²。在测量左心室壁厚度或左心室质量指数方面，两种设备之间未发现显著差异。两种设备在LVH评估方面的一致性为86%（kappa = 0.63）。手持设备预测LVH的敏感性、特异性、阳性预测值和阴性预测值分别为72%、91%、73%和90%。因此，手持超声心动图设备能够准确评估LVH，可用于对目标高血压患者进行基于社区的LVH筛查。