Su Fang-Ying, Lin Yen-Po, Lin Felicia, Yu Yun-Shun, Kwon Younghoon, Lu Henry Horng-Shing, Lin Gen-Min
Institute of Statistics, National Chiao Tung University, Hsinchu City.
Biotechnology R&D Center, National Taiwan University Hospital Hsinchu Branch, Hsinchu County.
Medicine (Baltimore). 2020 Oct 16;99(42):e22836. doi: 10.1097/MD.0000000000022836.
The performance of electrocardiographic (ECG) voltage criteria to identify left and right ventricular hypertrophy (LVH and RVH) in young Asian female adults have not been clarified so far.In a sample of 255 military young female adults, aged 25.2 years on average, echocardiographic LVH was respectively defined as the left ventricular mass (LVM) indexed by body surface area (BSA) (≥88 g/m) and by height (≥41 g/m), and RVH was defined as anterior right ventricular wall thickness >5.2 mm. The performance of ECG voltage criteria for the echocardiographic LVH and RVH were assessed by area under curve (AUC) of receiver operating characteristic (ROC) curve to estimate sensitivity and specificity.For the Sokolow-Lyon (the maximum of SV1 or SV2 + RV5 or RV6) and Cornell (RaVL + SV3) voltage criteria with the LVM/BSA ≥88 g/m, the AUC of ROC curves were 0.66 (95% confidence intervals [CI]: 0.52-0.81, P = .039) and 0.61 (95% CI: 0.44-0.77, P = .18), respectively. For these 2 ECG voltage criteria with the LVM/height ≥41 g/m, the AUC of ROC curves were 0.64 (95% CI: 0.52-0.75, P = 0.11) and 0.73 (95% CI: 0.61-0.85, P = 0.0074), respectively. The best cut-off points selected for the Sokolow-Lyon and Cornell voltage criteria with echocardiographic LVH in young Asian females were 26 mm and 6 mm, respectively. In contrast, all the AUC of ROC curves were less than 0.60 and not significant according to the Sokolow-Lyon (the maximum of RV1 + SV5 or V6) and Myers' voltage criteria (eg, the voltage of R wave in V1 and the ratios of R/S in V1, V5 and V6) with echocardiographic RVH.There was a suggestion that the ECG voltage criteria to screen the presence of LVH should be adjusted for the young Asian female adults, and with regard to RVH, the ECG voltage criteria were found ineffective.
心电图（ECG）电压标准在年轻亚洲成年女性中识别左心室肥厚（LVH）和右心室肥厚（RVH）的表现至今尚未明确。在255名平均年龄为25.2岁的年轻成年女性军人样本中，超声心动图LVH分别定义为以体表面积（BSA）（≥88 g/m²）和身高（≥41 g/m²）为指标的左心室质量（LVM），RVH定义为右心室前壁厚度>5.2 mm。通过受试者操作特征（ROC）曲线的曲线下面积（AUC）评估ECG电压标准对超声心动图LVH和RVH的表现，以估计敏感性和特异性。对于LVM/BSA≥88 g/m²的Sokolow-Lyon（SV1或SV2的最大值+RV5或RV）和Cornell（RaVL+SV3）电压标准，ROC曲线的AUC分别为0.66（95%置信区间[CI]：0.52-0.81，P = 0.039）和0.61（95%CI：0.44-0.77，P = 0.18）。对于LVM/身高≥41 g/m²的这两种ECG电压标准，ROC曲线的AUC分别为0.64（95%CI：0.52-0.75，P = 0.11）和0.73（95%CI：（0.61-0.85，P = 0.0074）。在年轻亚洲女性中，针对超声心动图LVH为Sokolow-Lyon和Cornell电压标准选择的最佳截断点分别为26 mm和6 mm。相比之下，根据Sokolow-Lyon（RV1+SV5或V6的最大值）和Myers电压标准（如V1中R波电压以及V1、V5和V6中R/S比值）评估超声心动图RVH时，所有ROC曲线的AUC均小于0.60且无统计学意义。有迹象表明，筛查LVH存在的ECG电压标准应针对年轻亚洲成年女性进行调整，而对于RVH，ECG电压标准无效。
