Kinoshita N, Onishi S, Yamazaki H, Katsukawa F, Yamada K
Sports Medicine Research Center, Keio University, Yokohama, Japan.
J Sci Med Sport. 2003 Dec;6(4):379-86. doi: 10.1016/s1440-2440(03)80264-5.
The efficacy of electrocardiography (ECG) in the diagnosis of left ventricular (LV) hypertrophy in 890 males, newly recruited to Japanese professional sumo wrestling (15.9 +/- 1.8 years of age, 177.8 +/- 4.7cm, 107.3 +/- 4.7kg), was tested by comparing simple, widely employed ECG criteria (Sokolow-Lyon chest and limb lead voltages and Cornell voltage with repolarisation criteria) with echocardiographic evaluations of LV mass indexed to body surface area. LV hypertrophy was defined as a LV mass index > 2 SD above the mean value obtained from 115 age-matched, normotensive, sedentary, male controls. The prevalence of LV hypertrophy as determined by echocardiography was 9.0% the entire group and was 8.3% among the 484 normotensives. The sensitivities of the three ECG criteria were < or = 36.0%, and their specificities were 70.0-99.0%. In contrast to the Sokolow-Lyon chest lead criteria, the diagnostic performance of the Cornell criteria was little affected by body mass index (BMI), and stepwise regression revealed that BMI did not significantly correlate with Cornell voltage. Still, the diagnostic efficacy of ECG was not sufficient to merit its use for primary recognition of LV hypertrophy among professional sumo wrestlers. Indeed, LV hypertrophy will likely go undetected by ECG in most overweight muscular athletes.
对890名新招募的日本职业相扑选手（年龄15.9±1.8岁，身高177.8±4.7厘米，体重107.3±4.7千克）进行了心电图（ECG）诊断左心室（LV）肥厚的效能测试，通过将简单且广泛应用的心电图标准（索科洛夫-里昂胸导联和肢体导联电压以及康奈尔电压与复极标准）与以体表面积为指标的左心室质量的超声心动图评估结果进行比较。左心室肥厚定义为左心室质量指数高于从115名年龄匹配、血压正常、久坐不动的男性对照者获得的平均值2个标准差以上。经超声心动图测定，整个组左心室肥厚的患病率为9.0%，484名血压正常者中为8.3%。这三种心电图标准的敏感性≤36.0%，其特异性为70.0 - 99.0%。与索科洛夫-里昂胸导联标准不同，康奈尔标准的诊断性能受体重指数（BMI）的影响很小，逐步回归显示BMI与康奈尔电压无显著相关性。尽管如此，心电图的诊断效能仍不足以使其用于职业相扑选手中左心室肥厚的初步识别。实际上，在大多数超重的肌肉发达的运动员中，心电图可能无法检测到左心室肥厚。
