Kimura M, Matsushita S, Nakahara K, Miyakawa A, Kuramoto K
Third Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
J Electrocardiol. 1987 Nov;20(5):369-74. doi: 10.1016/s0022-0736(87)80088-2.
The reliability of precordial electrocardiographic criteria for left ventricular hypertrophy (LVH) was evaluated by comparing it with the anatomical findings of 421 postmortem hearts examined by the chamber dissection technique. Of these 421 postmortem hearts, 136 without cardiovascular disease served as normal controls. The weights of the left ventricular free wall with interventricular septum (LV + S) and of the whole heart in normal controls were 153 +/- 36 grams (mean +/- SD) and 289 +/- 67 grams, respectively. Correlation coefficients between LV + S and whole heart were 0.89 for men and 0.90 for women. Anatomical LVH was defined as the weight of LV + S exceeding the average plus one standard deviation of that of a normal control heart. Anatomically established LVH was found in 99 (28%) of 353 cases having precordial electrocardiograms available for evaluation. The sensitivity, specificity, and predictive accuracy of electrocardiographic criteria for LVH were as follows: SV1 + RV5 greater than 3.5 mV, 56.6%, 76.0% and 47.9%; SV1 + RV5 greater than 4.0 mV, 45.5%, 87.4% and 58.4%; SV1 + RV5 greater than 5.0 mV, 21.2%, 94.5% and 60.0%; SV1 + RV5 greater than 3.5 mV with strain type ST-T, 35.4%, 93.3% and 67.3%; SV1 + RV5 greater than 4.0 mV with strain type ST-T, 29.3%, 94.9% and 69.0%; SV1 + RV5 greater than 5.0 mV with strain type ST-T, 14.1%, 98.0% and 73.7%; strain type ST-T, 36.4%, 92.5% and 65.5%; nonspecific ST-T, 26.3%, 76.4% and 30.2%; SV1 + RV5 greater than 3.5 mV with nonspecific ST-T, 12.1%, 93.3% and 41.4%; and right anteriorly directed T vector, 39.4%, 89.4% and 59.1%.(ABSTRACT TRUNCATED AT 250 WORDS)
通过将胸前心电图诊断左心室肥厚（LVH）的标准与采用心室解剖技术检查的421例尸检心脏的解剖结果进行比较，评估了该标准的可靠性。在这421例尸检心脏中，136例无心血管疾病者作为正常对照。正常对照中左心室游离壁加室间隔（LV + S）的重量和全心重量分别为153±36克（均值±标准差）和289±67克。男性和女性LV + S与全心重量之间的相关系数分别为0.89和0.90。解剖学上的LVH定义为LV + S的重量超过正常对照心脏均值加一个标准差。在可用于评估胸前心电图的353例病例中，99例（28%）有解剖学证实的LVH。LVH心电图标准的敏感性、特异性和预测准确性如下：SV1 + RV5大于3.5 mV，分别为56.6%、76.0%和47.9%；SV1 + RV5大于4.0 mV，分别为45.5%、87.4%和58.4%；SV1 + RV5大于5.0 mV，分别为21.2%、94.5%和60.0%；伴有ST-T劳损型的SV1 + RV5大于3.5 mV，分别为35.4%、93.3%和67.3%；伴有ST-T劳损型的SV1 + RV5大于4.0 mV，分别为29.3%、94.9%和69.0%；伴有ST-T劳损型的SV1 + RV5大于5.0 mV，分别为14.1%、98.0%和73.7%；ST-T劳损型，分别为36.4%、92.5%和65.5%；非特异性ST-T，分别为26.3%、76.4%和30.2%；伴有非特异性ST-T的SV1 + RV5大于3.5 mV，分别为12.1%、93.3%和41.4%；以及右前向T向量，分别为39.4%、89.4%和59.1%。（摘要截短于250字）
