Macfarlane P W, Chen C Y, Boyce B, Fraser R S
Br Heart J. 1981 Apr;45(4):402-10. doi: 10.1136/hrt.45.4.402.
A prospective study for the development of scoring techniques for the diagnosis of ventricular hypertrophy from the three orthogonal lead electrocardiogram was undertaken. A total of 51 hearts was examined at necropsy in a training group on which the scoring techniques were developed and a test group of a further 82 hearts was studied to assess the sensitivity and specificity of the method. The hearts were classified as being normal or having left ventricular hypertrophy, right ventricular hypertrophy, biventricular hypertrophy, or were placed in a borderline category. These classifications were based on the measurement of the weight of the left ventricular free wall, the interventricular septum, and the right ventricular free wall. Classical electrocardiographic variables were selected and assigned a point score on the basis of their diagnostic value. The electrocardiographic diagnosis of left ventricular hypertrophy, right ventricular hypertrophy, and biventricular hypertrophy was then made when the relevant score exceeded four points. After excluding 25 cases which showed conduction defects or were regarded as borderline at necropsy, 57 cases remained in the test group for assessing the technique. The sensitivity and specificity for left ventricular hypertrophy were 65 per cent and 91 per cent, respectively. For right ventricular hypertrophy corresponding results were 53 and 90 per cent. For biventricular hypertrophy the sensitivity was lower at 42 per cent, with a corresponding specificity of 93 per cent. These results represent a considerable improvement over older techniques, with up to a tenfold increase in sensitivity being obtained. The technique can be applied with or without computer assistance.
开展了一项前瞻性研究，旨在开发用于从三导联正交心电图诊断心室肥大的评分技术。在一个训练组中，对51颗心脏进行了尸检，据此开发评分技术，另外还对一个由82颗心脏组成的测试组进行了研究，以评估该方法的敏感性和特异性。心脏被分类为正常、左心室肥大、右心室肥大、双心室肥大或归为临界类别。这些分类基于左心室游离壁、室间隔和右心室游离壁重量的测量。选择了经典的心电图变量，并根据其诊断价值赋予一个分数。当相关分数超过4分时，做出左心室肥大、右心室肥大和双心室肥大的心电图诊断。在排除25例尸检显示传导缺陷或被视为临界的病例后，测试组中剩下57例用于评估该技术。左心室肥大的敏感性和特异性分别为65%和91%。右心室肥大的相应结果为53%和90%。双心室肥大的敏感性较低，为42%，相应的特异性为93%。这些结果表明与旧技术相比有了显著改进，敏感性提高了多达10倍。该技术可在有或没有计算机辅助的情况下应用。
