疑似肺动脉高压患者右心室压力超负荷的心电图检测
Electrocardiographic detection of right ventricular pressure overload in patients with suspected pulmonary hypertension.
作者信息
Kamphuis Vivian P, Haeck Marlieke L A, Wagner Galen S, Maan Arie C, Maynard Charles, Delgado Victoria, Vliegen Hubert W, Swenne Cees A
机构信息
Department of Cardiology, Leiden University Medical Center, The Netherlands.
Department of Cardiology, Duke University, NC, USA.
出版信息
J Electrocardiol. 2014 Mar-Apr;47(2):175-82. doi: 10.1016/j.jelectrocard.2013.10.010. Epub 2013 Nov 1.
BACKGROUND AND PURPOSE
Early, preferably noninvasive, detection of pulmonary hypertension improves prognosis. Our study evaluated the diagnostic accuracy of the electrocardiographically derived Butler-Leggett (BL) score and ventricular gradient (VG) to estimate mean pulmonary artery pressure (PAP).
METHODS
In 63 patients with suspected pulmonary hypertension, BL score and VG were calculated. The VG was projected on a direction optimized for detection of right ventricular pressure overload (VG-RVPO). BL score and VG-RVPO were entered in multiple linear regression analysis and the diagnostic performance to detect PH (invasively measured mean PAP ≥ 25 mmHg) was assessed with receiver operating characteristic analysis.
RESULTS
Both BL score and VG-RVPO correlated significantly with mean PAP (r=0.45 and r=0.61, respectively; P<0.001). Combining BL score and VG-RVPO increased the correlation to 0.67 (P<0.001). The diagnostic performance of this combination for the detection of PH was good with an area under the curve of 0.79 (P<0.001).
CONCLUSION
Combination of the BL score and VG-RVPO allows for accurate detection of increased PAP.
背景与目的
早期（最好是非侵入性的）检测肺动脉高压可改善预后。我们的研究评估了通过心电图得出的巴特勒 - 莱格特（BL）评分和心室梯度（VG）用于估计平均肺动脉压（PAP）的诊断准确性。
方法
对63例疑似肺动脉高压患者计算BL评分和VG。将VG投影到针对检测右心室压力过载优化的方向上（VG - RVPO）。将BL评分和VG - RVPO纳入多元线性回归分析，并通过受试者工作特征分析评估检测肺动脉高压（有创测量的平均PAP≥25 mmHg）的诊断性能。
结果
BL评分和VG - RVPO均与平均PAP显著相关（分别为r = 0.45和r = 0.61；P < 0.001）。将BL评分和VG - RVPO相结合，相关性提高到0.67（P < 0.001）。该组合检测肺动脉高压的诊断性能良好，曲线下面积为0.79（P < 0.001）。
结论
BL评分和VG - RVPO相结合可准确检测出升高的PAP。
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