Pannarale G, Gattini G, Ciolli A, Ricci R, Gaudio C, Pizzuto F, Reale A
Cardiologia. 1989 Jun;34(6):559-62.
The aim of the study was the assessment of the sensitivity, specificity and accuracy of some ECG criteria of left ventricular hypertrophy (LVH). Left ventricular mass (LVM) measured on the M-mode echogram of the left ventricle was the reference standard. Ninety-four (94) unselected, consecutive clinical patients (34 women, 60 men, average age 47 years) underwent in the same day, ECG and echocardiogram. Exclusion criteria were the presence of ischemic heart disease, atrial fibrillation and Wolff-Parkinson-White syndrome. The ECG tracings were interpreted independently by 2 investigators following 5 independent criteria of LVH: 1) Sokolow-Lyon voltage criterion (SL); 2) a modified Romhilt-Estes point score (REM); 3) left atrial abnormality (LAA); 4) left ventricular strain; 5) a new voltage criterion RaVL + SV3 corrected by sex and age. The left ventricular M-mode echograms were recorded using a left parasternal approach and were interpreted independently by 2 investigators. LVM was measured using the "Penn convention" and taking the R wave peak as end-diastole. The prevalence of LVH (= LVM 215 g) in the study population was 47%. The following results were achieved (sensitivity, specificity, accuracy): SL: 68.2%, 84%, 76.6%; REM: 63.6%, 90%, 77.7%: LAA: 36.4%, 84%, 61.7%; strain 52.3%, 72%, 62.8%; RaVL + SV3: 54.5%, 82%, 69.1%. Our data suggest: 1) the high sensitivity, specificity and accuracy of Romhilt-Estes point score are confirmed; 2) the sensitivity of Sokolow-Lyon voltage criterion is reevaluated; 3) the most sensitive morphological criterion seems to be the left ventricular strain; 4) a new voltage criterion could be useful.
本研究旨在评估左心室肥厚（LVH）的某些心电图标准的敏感性、特异性和准确性。以左心室M型超声心动图测量的左心室质量（LVM）作为参考标准。94例未经挑选的连续临床患者（34名女性，60名男性，平均年龄47岁）于同一天接受了心电图和超声心动图检查。排除标准为存在缺血性心脏病、心房颤动和预激综合征。2名研究人员根据5项独立的LVH标准对心电图进行独立解读：1）索科洛-里昂电压标准（SL）；2）改良的罗米尔-埃斯特点数法（REM）；3）左心房异常（LAA）；4）左心室劳损；5）一项根据性别和年龄校正的新电压标准RaVL + SV3。使用胸骨旁左路记录左心室M型超声心动图，并由2名研究人员独立解读。采用“宾夕法尼亚惯例”测量LVM，并将R波峰值作为舒张末期。研究人群中LVH（= LVM 215 g）的患病率为47%。得出以下结果（敏感性、特异性、准确性）：SL：68.2%，84%，76.6%；REM：63.6%，90%，77.7%；LAA：36.4%，84%，61.7%；劳损：52.3%，72%，62.8%；RaVL + SV3：54.5%，82%，69.1%。我们的数据表明：1）罗米尔-埃斯特点数法的高敏感性、特异性和准确性得到证实；2）重新评估了索科洛-里昂电压标准的敏感性；3）最敏感的形态学标准似乎是左心室劳损；4）一项新的电压标准可能有用。
