Yi Song, Wang Fang, Wan Minna, Yi Xiangwu, Zhang Yonggeng, Sun Shu
Department of Cardiovascular Ward 2, The people's hospital of Yichun city, Yichun, Jiangxi Province 336000, China.
Department of Cardiovascular Ward 1, The people's hospital of Yichun city, Yichun, Jiangxi Province 336000, China.
J Electrocardiol. 2020 Jul-Aug;61:27-31. doi: 10.1016/j.jelectrocard.2020.04.018. Epub 2020 Apr 28.
Electrocardiographic left ventricular hypertrophy (LVH) has been used to predict adverse prognosis in hypertensive patients. This meta-analysis aimed to investigate the association between LVH using the different electrocardiographic criteria in patients with hypertension.
A comprehensive literature search was performed PubMed and Embase databases up to September 1, 2019. Observational studies evaluating the association between electrocardiographic LVH (Cornell voltage, Cornell product or Sokolow-Lyon voltage) at baseline and risk of stroke among hypertensive patients were selected. The risk ratio (RR) with 95% confidence interval (CI) was pooled for patients with electrocardiographic LVH versus without LVH.
Seven studies enrolling 58,098 hypertensive patients were included. When compared those with or without LVH patients showed that the pooled RR of stroke was 1.63 (95% CI 1.38-1.93) for Cornell voltage criteria, 1.41 (95% CI 1.07-1.86) for Cornell product criteria, and 1.42 (95% CI 1.20-1.69) for Sokolow-Lyon voltage criteria, respectively. However, the predictive significance of Cornell product criteria was not reliable in the sensitivity analysis.
Baseline electrocardiographic LVH detecting by Sokolow-Lyon or Cornell voltage criteria can predict the development of stroke in hypertensive patients. Use of electrocardiographic LVH can improve stroke risk stratification in hypertensive patients.
心电图左心室肥厚（LVH）已被用于预测高血压患者的不良预后。本荟萃分析旨在研究高血压患者中使用不同心电图标准检测LVH之间的关联。
截至2019年9月1日，在PubMed和Embase数据库中进行了全面的文献检索。选择评估高血压患者基线时心电图LVH（康奈尔电压、康奈尔乘积或索科洛夫-里昂电压）与中风风险之间关联的观察性研究。汇总心电图LVH患者与无LVH患者的风险比（RR）及95%置信区间（CI）。
纳入了7项研究，共58098例高血压患者。比较有或无LVH的患者时发现，对于康奈尔电压标准，中风的汇总RR为1.63（95%CI 1.38 - 1.93）；对于康奈尔乘积标准，为1.41（95%CI 1.07 - 1.86）；对于索科洛夫-里昂电压标准，为1.42（95%CI 1.20 - 1.69）。然而，在敏感性分析中，康奈尔乘积标准的预测意义不可靠。
通过索科洛夫-里昂或康奈尔电压标准检测的基线心电图LVH可预测高血压患者中风的发生。使用心电图LVH可改善高血压患者的中风风险分层。
