Southern General Hospital, Glasgow, UK.
Pulm Circ. 2011 Oct-Dec;1(4):470-4. doi: 10.4103/2045-8932.93546.
In patients with pulmonary arterial hypertension (PAH), right ventricular mass (RVM) correlates linearly with pulmonary artery pressure, and decreases with successful treatment. Accurate measurement of RVM currently requires cardiovascular magnetic resonance (CMR) imaging. We therefore tested the relationship between RVM and a simple, 12 lead ECG-derived value, the Butler-Leggett (BL) score. This has previously been validated in patients with RV hypertrophy (RVH) due to mitral stenosis. We also tested the diagnostic accuracy of the BL score in detecting RVH. The Scottish Pulmonary Vascular Unit database was reviewed retrospectively. Twenty-eight patients with PAH were identified, in whom CMR and ECG data had been recorded no more than 28 days apart. All had completed a comprehensive clinical assessment, including right heart catheterization. CMR-derived absolute RVM and RV mass index (RVMI=RV mass/LV mass) were correlated against BL score. The ability of this score to detect RVH was tested using 2 x 2 contingency tables. RVM and RVMI correlated with BL score (r=0.77, P<0.001 and r=0.78, P<0.001, respectively). A BL score >0.7 mV proved a highly specific but insensitive indicator of RVH, based on either absolute RVM (sensitivity 74%, specificity 100%) or a high RVMI (sensitivity 61%, specificity 100%). The BL score, which can be defined using a standard 12-lead ECG, correlates with RVM and RVMI in patients with PAH. A score >0.7 mV was a highly specific but insensitive indicator of RVH in these patients.
在肺动脉高压（PAH）患者中，右心室质量（RVM）与肺动脉压力呈线性相关，并且随着治疗的成功而降低。RVM 的准确测量目前需要心血管磁共振（CMR）成像。因此，我们测试了 RVM 与简单的 12 导联心电图衍生值 Butler-Leggett（BL）评分之间的关系。该评分先前已在因二尖瓣狭窄而导致 RV 肥厚（RVH）的患者中得到验证。我们还测试了 BL 评分在检测 RVH 中的诊断准确性。回顾性地审查了苏格兰肺血管单位数据库。确定了 28 名患有 PAH 的患者，在这些患者中，CMR 和 ECG 数据的记录时间不超过 28 天。所有患者均完成了全面的临床评估，包括右心导管检查。CMR 衍生的绝对 RVM 和 RV 质量指数（RVMI=RV 质量/LV 质量）与 BL 评分相关。使用 2 x 2 列联表测试了该评分检测 RVH 的能力。RVM 和 RVMI 与 BL 评分相关（r=0.77，P<0.001 和 r=0.78，P<0.001）。BL 评分>0.7 mV 证明是一种高度特异但不敏感的 RVH 指标，基于绝对 RVM（敏感性 74%，特异性 100%）或高 RVMI（敏感性 61%，特异性 100%）。BL 评分可以使用标准的 12 导联心电图定义，与 PAH 患者的 RVM 和 RVMI 相关。评分>0.7 mV 是这些患者 RVH 的高度特异但不敏感的指标。
