Angeli Fabio, Verdecchia Paolo, Cavallini Claudio, Aita Adolfo, Turturiello Dario, Mazzotta Giovanni, Trapasso Monica, De Fano Michelantonio, Reboldi Gianpaolo
Division of Cardiology and Cardiovascular Pathophysiology, Hospital S. Maria Della Misericordia, Perugia, Italy.
Fondazione Umbra Cuore e Ipertensione-ONLUS, Division of Cardiology, Hospital S. Maria Della Misericordia, Perugia, Italy.
Int J Cardiol Hypertens. 2019 Apr 10;1:100004. doi: 10.1016/j.ijchy.2019.100004. eCollection 2019 May.
Left ventricular (LV) hypertrophy at electrocardiography (ECG) predicts incident atrial fibrillation (AF). However, the diagnostic performance of ECG for diagnosis of LV hypertrophy in patients with AF is still not well characterized. We analyzed 563 hypertensive patients enrolled in the Umbria-Atrial Fibrillation (Umbria-FA) registry, an ongoing prospective observational registry in patients with AF. All patients underwent ECG and standard echocardiography at their entry in the Register. Mean age was 74 years and 43% of patients were women. Prevalence of ECG-LV hypertrophy, defined by Perugia criterion corrected for body mass index, was 23%. Echocardiographic LV mass was the reference standard. Sensitivity, specificity and diagnostic accuracy of ECG-LV hypertrophy were 37.4% (95% confidence interval [CI]: 31.6-43.4), 90.0% (95% CI: 86.0-93.2) and 64.5% (95% CI: 60.4-68.3), respectively. Performance was comparable in patients with AF or sinus rhythm at ECG recording. The area under the receiver-operating characteristic (ROC) curve was 0.622 (95% CI: 0.580-0.664) in the group with AF and 0.662 (95% CI: 0.605-0.720) in that with sinus rhythm (p = 0.266 for comparison). These data suggest that standard ECG is reliable for diagnosis of LV hypertrophy in patients with a history of AF, regardless of the presence of AF or sinus rhythm at the time of ECG recording.
心电图（ECG）显示的左心室（LV）肥厚可预测房颤（AF）的发生。然而，ECG对房颤患者左心室肥厚的诊断效能仍未得到充分描述。我们分析了纳入翁布里亚房颤（Umbria-FA）注册研究的563例高血压患者，这是一项针对房颤患者的正在进行的前瞻性观察性注册研究。所有患者在进入注册研究时均接受了ECG和标准超声心动图检查。平均年龄为74岁，43%的患者为女性。根据经体重指数校正的佩鲁贾标准定义的ECG-LV肥厚患病率为23%。超声心动图测定的左心室质量为参考标准。ECG-LV肥厚的敏感性、特异性和诊断准确性分别为37.4%（95%置信区间[CI]：31.6-43.4）、90.0%（95%CI：86.0-93.2）和64.5%（95%CI：60.4-68.3）。在ECG记录时房颤或窦性心律的患者中，其诊断效能相当。房颤组的受试者工作特征（ROC）曲线下面积为0.622（95%CI：0.580-0.664），窦性心律组为0.662（95%CI：0.605-0.720）（比较p = 0.266）。这些数据表明，标准ECG对于有房颤病史的患者诊断左心室肥厚是可靠的，无论ECG记录时是房颤还是窦性心律。
