Shao Qingmiao, Meng Lei, Tse Gary, Sawant Abhishek C, Zhuo Yi Chan Calista, Bazoukis George, Baranchuk Adrian, Li Guangping, Liu Tong
Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China.
Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China.
Ann Noninvasive Electrocardiol. 2019 Mar;24(2):e12602. doi: 10.1111/anec.12602. Epub 2018 Oct 3.
The electrocardiographic criteria currently available for the diagnosis of left ventricular hypertrophy (LVH) are low in sensitivity. Thus, we compared the diagnostic performance of newly proposed electrocardiographic criteria to the existing criteria in a Chinese population.
A total of 235 consecutive hypertensive patients, hospitalized in our department between May 2017 and April 2018, were included. They were divided into two groups based on the gold standard echocardiogram: those with (n = 116) and without LVH (n = 119). The newly proposed ECG criteria were calculated by summating the amplitude of the deepest S wave (S ) in any single lead and the S-wave amplitude of lead V (S ). The area under the curve was calculated and compared against the sex-specific Cornell limb lead and Sokolow-Lyon criteria.
ECG analysis of the cohort showed that the newly proposed criteria had the highest sensitivity in diagnosing LVH (male: 65.5%; female: 81%), followed by the Cornell limb lead criteria (male: 55.2%; female: 56.9%). The specificities of both sets of criteria were higher than 70%, with no significant differences between them. Receiver operator curve analysis showed an optimal cutoff of ≥2.1 mV for females (AUC: 0.832; 95% CI: 0.757-0.906) and ≥2.6 mV for males (AUC: 0.772; 95% CI: 0.687-0.856).
The newly proposed S + S criteria provide an improved sensitivity for the ECG diagnosis of LVH compared to existing criteria, but its routine use will require further validation in larger populations.
目前用于诊断左心室肥厚（LVH）的心电图标准敏感性较低。因此，我们在中国人群中比较了新提出的心电图标准与现有标准的诊断性能。
纳入2017年5月至2018年4月在我科住院的235例连续高血压患者。根据金标准超声心动图将他们分为两组：有LVH的患者（n = 116）和无LVH的患者（n = 119）。通过将任何单导联中最深S波（S）的振幅与V导联的S波振幅（S）相加来计算新提出的心电图标准。计算曲线下面积，并与性别特异性的康奈尔肢体导联和索科洛夫 - 里昂标准进行比较。
该队列的心电图分析表明，新提出的标准在诊断LVH方面具有最高的敏感性（男性：65.5％；女性：81％），其次是康奈尔肢体导联标准（男性：55.2％；女性：56.9％）。两组标准的特异性均高于70％，两者之间无显著差异。受试者工作特征曲线分析显示，女性的最佳截断值≥2.1mV（AUC：0.832；95％CI：0.757 - 0.906），男性的最佳截断值≥2.6mV（AUC：0.772；95％CI：0.687 - 0.856）。
与现有标准相比，新提出的S + S标准在心电图诊断LVH方面提供了更高的敏感性，但其常规使用需要在更大的人群中进一步验证。
