Puchalski Michael D, Lozier John S, Bradley David J, Minich L LuAnn, Tani Lloyd Y
Department of Pediatrics, Primary Children's Medical Center and University of Utah School of Medicine, Salt Lake City, Utah 84113, USA.
Pediatrics. 2006 Sep;118(3):1052-5. doi: 10.1542/peds.2005-2985.
Although the electrocardiogram is commonly obtained in the evaluation of patients with pulmonary hypertension, its value as a screening test for right ventricular hypertrophy or pulmonary hypertension is unclear. Therefore, we sought to determine the value of an electrocardiogram in the diagnosis of right ventricular hypertrophy using echocardiography as the gold standard.
We identified children without congenital heart disease who underwent evaluation for suspected pulmonary hypertension that included both an electrocardiogram and echocardiography within a specified time frame.
A total of 76 echocardiography-electrocardiogram pairs for pulmonary hypertension were identified. Although there was a significant relationship between electrocardiogram and echocardiography evidence of right ventricular hypertrophy, the sensitivity of an electrocardiogram in diagnosing echocardiography-documented right ventricular hypertrophy was only 69%, and the positive predictive value was 67%. There was no relationship between electrocardiogram changes and Doppler tricuspid regurgitation gradient.
Despite a statistically significant relationship between an electrocardiogram and echocardiography in the diagnosis of right ventricular hypertrophy, an electrocardiogram has limited value as a screening tool for right ventricular hypertrophy because of its relatively low sensitivity and positive predictive value.
虽然心电图常用于评估肺动脉高压患者，但其作为右心室肥厚或肺动脉高压筛查试验的价值尚不清楚。因此，我们试图以超声心动图作为金标准来确定心电图在诊断右心室肥厚中的价值。
我们纳入了无先天性心脏病且在特定时间内接受疑似肺动脉高压评估（包括心电图和超声心动图检查）的儿童。
共确定了76对用于肺动脉高压诊断的超声心动图 - 心电图组合。虽然心电图与超声心动图显示的右心室肥厚证据之间存在显著相关性，但心电图诊断超声心动图证实的右心室肥厚的敏感性仅为69%，阳性预测值为67%。心电图变化与多普勒三尖瓣反流梯度之间无相关性。
尽管心电图与超声心动图在诊断右心室肥厚方面存在统计学上的显著相关性，但由于其相对较低的敏感性和阳性预测值，心电图作为右心室肥厚的筛查工具价值有限。
