Otterstad J E, Froeland G, Wasenius A K, Knutsen K M, Michelsen S, Stugaard M
Department of Internal Medicine, Vestfold Central Hospital, Toensborg, Norway.
J Hum Hypertens. 1991 Apr;5(2):101-6.
The diagnostic validity of ECG criteria for left ventricular hypertrophy (LVH) was assessed in 100 men aged 22-64 (mean 47) years with moderate hypertension (Group 1) and 95 age-matched normotensive men (Group 2) using echocardiographic recordings of LV mass index (MI) as reference. A diagnosis of LVH was made in subjects with LVMI greater than or equal to 125 g/m2. Mean LVMI was 126 +/- 34 g/m2 in Group 1 vs. 100 +/- g/m2 in Group 2 (P less than 0.001), and the prevalence of LVH was 48% and 11% respectively (P less than 0.001). The mean ECG voltage according to Sokolow-Lyon (S-L) was 28 +/- 8 mm in Group 1 and 27 +/- 7 mm in Group 2 (NS); with 19% having LVH in Group 1 and 14% in Group 2 (NS). Using the Cornell criterion Group 1 had on average 15 +/- 6 mm vs. 12 +/- 5 mm in Group 2 (P less than 0.001), but only two Group 1 patients had LVH. In Group 2 a significant negative correlation between age and S-L voltage was found (r = 0.33, P less than 0.001). LVMI was not correlated with any of the two voltage criteria using linear regression analysis whereas multiple regression analysis revealed a weak, but significant correlation between LVMI and S-L voltage in Group 1 (t = 2.06, P = 0.04). No subject had LV strain pattern or LVH according to the Romhilt Estes point score system. In the assessment of possible LVH in normal or moderately hypertensive men less than 65-70 years of age, ECG has limited value.
以左心室质量指数（MI）的超声心动图记录为参考，对100名年龄在22至64岁（平均47岁）的中度高血压男性（第1组）和95名年龄匹配的血压正常男性（第2组）评估了心电图诊断左心室肥厚（LVH）标准的有效性。左心室质量指数（LVMI）大于或等于125g/m²的受试者被诊断为LVH。第1组的平均LVMI为126±34g/m²，第2组为100±g/m²（P<0.001），LVH的患病率分别为48%和11%（P<0.001）。根据索科洛夫-里昂（S-L）标准，第1组的平均心电图电压为28±8mm，第2组为27±7mm（无显著差异）；第1组中19%的人有LVH，第2组中为14%（无显著差异）。采用康奈尔标准，第1组平均为15±6mm，第2组为12±5mm（P<0.001），但第1组只有两名患者有LVH。在第2组中，发现年龄与S-L电压之间存在显著负相关（r = 0.33，P<0.001）。使用线性回归分析，LVMI与两个电压标准中的任何一个均无相关性，而多元回归分析显示第1组中LVMI与S-L电压之间存在微弱但显著的相关性（t = 2.06，P = 0.04）。根据罗米尔-埃斯蒂斯积分系统，没有受试者有左心室应变模式或LVH。在评估年龄小于65至70岁的正常或中度高血压男性中可能存在的LVH时，心电图的价值有限。
