Department of Cardiology, University Hospital Erlangen, Erlangen, Germany.
Wien Klin Wochenschr. 2011 Aug;123(15-16):502-7. doi: 10.1007/s00508-011-0004-1. Epub 2011 Jul 5.
The study was conducted to ascertain that the ECG assists in the assessment of systolic dysfunction in chronic aortic regurgitation. Five variables were reviewed in 146 adults without bundle branch block who underwent angiocardiography: total 12-lead QRS amplitude, QRS duration, maximum R peak time in I, V5 or V6, maximum R peak time relative to S peak time of the maximum S in V1, V2 or V3, and maximum T wave amplitude and polarity in I, V6 or aVF. In order to define which of them could differentiate left ventricular ejection fraction (EF) ≥50% (n = 101) from EF <50% (n = 45) they were subjected to stepwise linear discriminant analysis. The maximum R peak time relative to S peak time emerged as the most promising variable. In predicting EF <50%, R peak time prolongation exceeding S peak time, i.e. R peak delay, yields reliable results, with specificity, positive and negative predictive value being 89.1%, 70.3% and 82.6%, respectively, and sensitivity being 57.8%. As given by the sample odds-ratio, R peak delay indicates an 11-fold increased risk of having EF <50%. R peak delay, a marker of left ventricular function-conduction impairment identifies patients who need valve replacement.
本研究旨在确定心电图（ECG）有助于评估慢性主动脉瓣反流患者的收缩功能障碍。在 146 名未发生束支传导阻滞的成年人中，回顾了五个变量：12 导联心电图总 QRS 波振幅、QRS 波持续时间、I、V5 或 V6 导联最大 R 波峰时间、V1、V2 或 V3 导联最大 S 波峰时间至最大 R 波峰时间的比值、I、V6 或 aVF 导联最大 T 波振幅和极性。为了确定哪些变量可以区分左心室射血分数（EF）≥50%（n=101）和 EF<50%（n=45），我们对它们进行了逐步线性判别分析。最大 R 波峰时间与 S 波峰时间的比值是最有前途的变量。在预测 EF<50%时，R 波峰时间延长超过 S 波峰时间，即 R 波延迟，可获得可靠的结果，特异性、阳性预测值和阴性预测值分别为 89.1%、70.3%和 82.6%，敏感性为 57.8%。根据样本比值比，R 波延迟表明 EF<50%的风险增加了 11 倍。R 波延迟是左心室功能-传导障碍的标志物，可识别需要瓣膜置换的患者。
