Division of Cardiology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, Korea.
Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, Korea.
Int J Environ Res Public Health. 2021 Dec 7;18(24):12867. doi: 10.3390/ijerph182412867.
Low QRS voltage (LQRSV) in electrocardiography (ECG) often occurs in limb leads without apparent cause. However, its clinical significance is obscure in healthy populations. We reviewed patients aged over 60 who were scheduled for non-cardiac surgery in two hospitals. Patients underwent pre-operative ECG, echocardiography, pulmonary function test, and chest X-ray. Patients with LQRSV isolated to limb leads and patients without LQRSV were selected from separate hospitals. Among the 9832 patients screened in one hospital, 292 (3.0%) showed LQRSV in limb leads. One-hundred and ninety-four without LQRSV were selected as the control from the 216 patients screened at the other hospital. For primary analysis, patients with structural heart disease or classic etiologies of LQRSV were excluded. Patients with LQRSV had a higher proportion of male and a greater body mass index. Precordial QRS voltages were smaller, whereas left ventricular mass index and the prevalence of echocardiographic left ventricular hypertrophy (LVH) was higher in patients with LQRSV than in those without. Consequentially, diagnostic performance of precordial voltage criteria for LVH was particularly poor in patients with LQRSV in limb leads. LQRSV in limb leads frequently occurs without apparent etiologies. ECG voltage criteria may underestimate LVH in a relatively healthy population with LQRSV in limb leads.
心电图（ECG）中的低 QRS 电压（LQRSV）在肢体导联中常无明显原因发生。然而，在健康人群中，其临床意义尚不清楚。我们回顾了在两家医院接受非心脏手术的 60 岁以上患者。患者接受了术前心电图、超声心动图、肺功能检查和胸部 X 线检查。从单独的医院中选择了仅在肢体导联出现 LQRSV 的患者和无 LQRSV 的患者。在一家医院筛选的 9832 例患者中，292 例（3.0%）出现肢体导联 LQRSV。从另一家医院筛选的 216 例患者中选择了 194 例无 LQRSV 的患者作为对照组。在主要分析中，排除了有结构性心脏病或 LQRSV 经典病因的患者。有 LQRSV 的患者中男性比例更高，体重指数更大。胸前导联 QRS 电压较小，而左心室质量指数和超声心动图左心室肥厚（LVH）的患病率在有 LQRSV 的患者中高于无 LQRSV 的患者。因此，在肢体导联出现 LQRSV 的患者中，胸前导联电压标准诊断 LVH 的性能特别差。肢体导联中经常出现无明显病因的 LQRSV。在肢体导联有 LQRSV 的相对健康人群中，心电图电压标准可能低估 LVH。
