心电图和超声心动图信息相结合可识别出在5年内左心室质量可能逐渐增加的个体。

Combination of electrocardiographic and echocardiographic information identifies individuals prone to a progressive increase in left ventricular mass over 5 years.

作者信息

Reffelmann Thorsten, Dörr Marcus, Völzke Henry, Kors Jan, Ruppert Jörg, Robinson Daniel, Felix Stephan B

机构信息

aKlinik und Poliklinik für Innere Medizin B, Universitätsklinikum, Ernst-Moritz-Arndt-Universität Greifswald, Greifswald, Germany.

出版信息

J Hypertens. 2009 Apr;27(4):861-8. doi: 10.1097/HJH.0b013e328324f8e8.

DOI:10.1097/HJH.0b013e328324f8e8

PMID:19262408

Abstract

OBJECTIVE

We assessed whether the relationship between electrocardiographic and echocardiographic information on left ventricular hypertrophy predicts the development of left ventricular mass over 5 years.

METHODS

Linear regression analyses between various electrocardiographic indices of left ventricular hypertrophy and left ventricular mass (echocardiography) indexed to height2.7 (LVMI(ht)) was performed in 1488 individuals in each gender subgroup (45-79 years, 841 female, exclusion of intraventricular conduction defects) from the population-based, longitudinal 'Study of Health in Pomerania'. A parameter expressing the difference between observed ECG indices of left ventricular hypertrophy and ECG indices predicted on the basis of echocardiographic readings was calculated in each individual at the baseline visit.

RESULTS

In individuals with complete echocardiographic data at baseline and 5-year-follow-up (n = 1031, exclusion of aortic valve disease), LVMI(ht) at 5-year-follow-up was significantly correlated with the parameter derived from the Cornell product (P < 0.001), the Cornell voltage (P < 0.001), the Gubner-Ungerleider-product (P < 0.001), the Gubner-Ungerleider-voltage (P < 0.001), Lewis voltage (P < 0.001) and aVL voltage (P < 0.001), but not with Sokolow-Lyon-index-derived parameters. LVMI(ht) at baseline did not significantly correlate with any of these ECG-derived parameters. In female individuals with Cornell products higher than expected based on echocardiographic readings, left ventricular mass increased from 162.3 +/- 2.6 g to 180.5 +/- 2.8 g (males: 213.1 +/- 3.7 g to 236.3 +/- 4.2 g), whereas left ventricular mass increased only from 161.8 +/- 2.5 g to 173.5 +/- 2.8 g (males: 209.7 +/- 3.7 g to 215.8 +/- 3.7 g) in individuals with lower than expected Cornell products (P < 0.001).

CONCLUSION

The relationship of electrocardiographic and echocardiographic information on left ventricular mass may identify individuals at risk for developing progressive increase in left ventricular mass.

摘要

目的

我们评估了心电图与超声心动图关于左心室肥厚的信息之间的关系是否能预测5年内左心室质量的变化。

方法

在基于人群的纵向“波美拉尼亚健康研究”中，对每个性别亚组（45 - 79岁，841名女性，排除室内传导阻滞）的1488名个体进行了左心室肥厚的各种心电图指标与身高2.7指数化的左心室质量（超声心动图）之间的线性回归分析。在基线访视时计算每个个体中一个表示左心室肥厚的观察到的心电图指标与基于超声心动图读数预测的心电图指标之间差异的参数。

结果

在基线和5年随访时有完整超声心动图数据的个体（n = 1031，排除主动脉瓣疾病）中，5年随访时的左心室质量指数（LVMI(ht)）与从康奈尔乘积（P < 0.001）、康奈尔电压（P < 0.001）、古布纳 - 昂格勒德乘积（P < 0.001）、古布纳 - 昂格勒德电压（P < 0.001）、刘易斯电压（P < 0.001）和aVL电压（P < 0.001）得出的参数显著相关，但与索科洛 - 里昂指数得出的参数无关。基线时的LVMI(ht)与这些基于心电图得出的参数均无显著相关性。在康奈尔乘积高于基于超声心动图读数预期值的女性个体中，左心室质量从162.3±2.6 g增加到180.5±2.8 g（男性：从213.1±3.7 g增加到236.3±4.2 g），而在康奈尔乘积低于预期值的个体中，左心室质量仅从161.8±2.5 g增加到173.5±2.8 g（男性：从209.7±3.7 g增加到215.8±3.7 g）（P < 0.001）。