Murphy M L, Thenabadu P N, de Soyza N, Doherty J E, Meade J, Baker B J, Whittle J L
Am J Cardiol. 1984 Apr 1;53(8):1140-7. doi: 10.1016/0002-9149(84)90651-9.
Cardiac chamber weight was determined at necropsy in 323 men to develop correlative studies of electrocardiographic criteria for ventricular hypertrophy. Thirty recommended criteria for left ventricular (LV) hypertrophy, 10 for right ventricular (RV) hypertrophy, and combinations of both criteria for combined hypertrophy were evaluated. Four methods for electrocardiographic diagnosis of LV hypertrophy were derived: (1) a modification of the Romhilt-Estes point system; (2) the presence of any 1 of 3 criteria: (a) S V1 + R V5 or V6 greater than 35 mm, (b) left atrial abnormality, or (c) intrinsicoid deflection in lead V5 or V6 greater than or equal to 0.05 second; (3) a combination of any 2 criteria or of 1 criterion (above) plus at least 1 of the following 3 additional criteria: (a) left-axis deviation greater than -30 degrees, (b) QRS duration greater than 0.09 second, or (c) T-wave inversion in lead V6 of 1 mm or more; and (4) the use of a single criterion--left atrial abnormality. Sensitivity varied from 57 to 66% and specificity from 85 to 93% among these 4 methods. Myocardial infarction increased sensitivity of the foregoing methods, but the specificity was reduced. Method 2 is preferred for the electrocardiographic diagnosis of LV hypertrophy. Two methods were useful for right ventricular (RV) hypertrophy: (1) the use of any 1 of 4 criteria: (a) R/S ratio in lead V5 or V6 less than or equal to 1; (b) S V5 or V6 greater than or equal to 7 mm; (c) right-axis deviation of more than +90 degrees, or (d) P pulmonale; and (2) use of any 2 combinations of the foregoing criteria. Sensitivity ranged from 18 to 43% and specificity from 83 to 95%. Combined hypertrophy was best diagnosed using left atrial abnormality as the sole criteria of LV hypertrophy, plus any 1 of 3 criteria of RV hypertrophy: (a) R/S ratio in lead V5 or V6 less than or equal to 1, (b) S V5 or V6 greater than or equal to 7 mm, or (c) right axis deviation greater than +90 degrees.(ABSTRACT TRUNCATED AT 250 WORDS)
在323名男性尸检时测定心脏各腔室重量，以开展关于心室肥厚心电图标准的相关性研究。对30条推荐的左心室（LV）肥厚标准、10条右心室（RV）肥厚标准以及两者合并肥厚的联合标准进行了评估。得出了4种心电图诊断LV肥厚的方法：（1）对Romhilt-Estes评分系统的一种改良；（2）满足以下3条标准中的任何1条：（a）S V1 + R V5或V6大于35 mm，（b）左心房异常，或（c）V5或V6导联的类本位曲折大于或等于0.05秒；（3）任意2条标准的组合，或1条上述标准加上以下3条附加标准中的至少1条：（a）电轴左偏大于-30度，（b）QRS时限大于0.09秒，或（c）V6导联T波倒置1 mm或以上；（4）使用单一标准——左心房异常。这4种方法的敏感性在57%至66%之间，特异性在85%至93%之间。心肌梗死增加了上述方法的敏感性，但特异性降低。方法2是LV肥厚心电图诊断的首选方法。有2种方法对右心室（RV）肥厚有用：（1）使用以下4条标准中的任何1条：（a）V5或V6导联的R/S比值小于或等于1；（b）S V5或V6大于或等于7 mm；（c）电轴右偏大于+90度，或（d）肺型P波；（2）使用上述标准的任意2种组合。敏感性在18%至43%之间，特异性在83%至95%之间。合并肥厚的最佳诊断方法是，以左心房异常作为LV肥厚的唯一标准，加上RV肥厚3条标准中的任何1条：（a）V5或V6导联的R/S比值小于或等于1，（b）S V5或V6大于或等于7 mm，或（c）电轴右偏大于+90度。（摘要截断于250字）
