De Leonardis V, Goldstein S A, Lindsay J
Washington Hospital Center, Washington, DC 20010.
Am J Cardiol. 1988 Sep 15;62(9):590-3. doi: 10.1016/0002-9149(88)90661-3.
There are few data evaluating electrocardiographic diagnosis of left ventricular (LV) hypertrophy in the presence of right bundle branch block (BBB). This study assesses the relative value of multiple electrocardiographic variables for detecting LV hypertrophy in patients with right BBB. LV hypertrophy was defined as LV mass greater than or equal to 215 g calculated from the Penn method using standard M-mode echo measurements. Sixty-two patients were evaluated (ages 41 to 94) and 35 had LV hypertrophy. None of the electrocardiographic criteria was sensitive; the best was mean QRS axis less than or equal to -30 degrees (sensitivity) 52%) and excessive negative P terminal force (sensitivity 28%). Several electrocardiographic variables were specific: Sokolow index greater than or equal to 35 mm (100%), RV5 or RV6 greater than or equal to 25 mm (96.3%), RI + SIII greater than or equal to 25 mm (92.6%) and intrinsicoid deflection greater than or equal to 0.05 seconds (88.5%). Conventional electrocardiographic criteria do not reliably detect LV hypertrophy in the presence of right BBB, but several criteria are relatively specific for LV hypertrophy.
评估右束支传导阻滞（BBB）情况下左心室（LV）肥厚心电图诊断的资料很少。本研究评估了多个心电图变量对检测右束支传导阻滞患者左心室肥厚的相对价值。左心室肥厚定义为根据使用标准M型超声心动图测量的Penn方法计算得出的左心室质量大于或等于215克。对62例患者（年龄41至94岁）进行了评估，其中35例有左心室肥厚。没有一项心电图标准是敏感的；最佳标准是平均QRS电轴小于或等于-30度（敏感性52%）和P波终末负向力增大（敏感性28%）。几个心电图变量具有特异性：索科洛夫指数大于或等于35毫米（100%）、RV5或RV6大于或等于25毫米（96.3%）、RI + SIII大于或等于25毫米（92.6%）和类本位曲折大于或等于0.05秒（88.5%）。传统心电图标准不能可靠地检测右束支传导阻滞情况下的左心室肥厚，但有几个标准对左心室肥厚相对具有特异性。
