病态肥胖和超病态肥胖患者左心室肥厚临界值的有效性存疑。
Questionable validity of left ventricular hypertrophy cutoff values in morbidly and super-morbidly obese patients.
作者信息
Domienik-Karłowicz Justyna, Rymarczyk Zuzanna, Lisik Wojciech, Kurnicka Katarzyna, Ciurzyński Michał, Bielecki Maksymilian, Kosieradzki Maciej, Pruszczyk Piotr
机构信息
Department of Internal Medicine and Cardiology with the Center for Diagnosis and Treatment of Venous Thromboembolism, Medical University of Warsaw, Warsaw, Poland.
Department of General Surgery and Transplantology, Medical University of Warsaw, Warsaw, Poland.
出版信息
Ann Noninvasive Electrocardiol. 2018 Nov;23(6):e12564. doi: 10.1111/anec.12564. Epub 2018 Jun 17.
BACKGROUND
Current diagnostic ECG criteria of left ventricular hypertrophy in obese patients are still lacking.
OBJECTIVE
To assess the current ECG diagnostic criteria of LVH, and to validate our previously proposed criteria in a group of patients with morbid obesity.
METHODS
A group of consecutive 429 obese patients (MOP) with BMI of at least 35 kg/m (mean age 38.6 ± 8.9 years, BMI 48.7 ± 9.0 kg/m ; 323 females, 106 males) were included.
RESULTS
The diagnosis of LVH in MOPs was confirmed only by RaVL of 7.5 mm, Cornell index of 12.5 mm; Cornell index × QRS duration of 1,125 mm × ms and Romhilt-Estes score of 1. None of the criteria proposed to date is appropriate in super-morbidly obese patients.
CONCLUSION
Our study confirmed that none of the currently used voltage-based ECG criteria is appropriate for diagnosing LVH in morbidly obese patients. Further studies are required.
背景
目前仍缺乏肥胖患者左心室肥厚的诊断心电图标准。
目的
评估目前左心室肥厚的心电图诊断标准，并在一组病态肥胖患者中验证我们先前提出的标准。
方法
纳入一组连续的429例肥胖患者（病态肥胖患者），其体重指数至少为35kg/m²（平均年龄38.6±8.9岁，体重指数48.7±9.0kg/m²；女性323例，男性106例）。
结果
仅RaVL为7.5mm、康奈尔指数为12.5mm、康奈尔指数×QRS时限为1125mm×ms以及Romhilt-Estes评分为1可确诊病态肥胖患者的左心室肥厚。迄今为止提出的标准均不适用于超病态肥胖患者。
结论
我们的研究证实，目前使用的基于电压的心电图标准均不适用于诊断病态肥胖患者的左心室肥厚。需要进一步研究。
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