Cabezas M, Comellas A, Ramón Gómez J, López Grillo L, Casal H, Carrillo N, Camero R, Castillo R
Hospital Universitario de Caracas, Universidad Central de Venezuela, Venezuela.
Rev Esp Cardiol. 1997 Jan;50(1):31-5. doi: 10.1016/s0300-8932(97)73173-7.
Because left ventricular mass is associated with an increase in the risk of morbidity and mortality of cardiovascular diseases in the general population having the electrocardiogram as an accessible and inexpensive method for the diagnosis of left ventricular hypertrophy, we decided to calculate the sensitivity and specificity of 5 electrocardiographic criteria for the diagnosis of left ventricular hypertrophy and to compare the results of the original authors to ours.
135 patients were evaluated; 46 patients were excluded by the following criteria: chronic obstructive pulmonary disease, complete left or right bundle branch block, cardiovascular ischemic disease or Wolf-Parkinson-White Syndrome. 89 patients remained and had an electrocardiogram performed applying the following criteria: Romhilt-Estes Point-Score system. Sokolow-Lyon (SV1 + RV5 or V6 > 3.5 mV) and (RaVL > 1.1 mV), Cornell and Rodríguez Padial. Left ventricular hypertrophy was defined by the Penn Convention Criteria.
In our study we obtained the following results: a) Romhilt-Estes had a sensitivity of 12% and a specificity of 87%; b) Sokolow-Lyon (SV1 + RV5 or V6) had a sensitivity of 22% and a specificity of 79%; c) Sokolow-Lyon (RaVL) has a sensitivity of 18% and a specificity of 92%; d) Cornel had a sensitivity of 31% and a specificity of 87%, and e) Rodríguez Padial had a sensitivity of 82% and a specificity of 8%. There are similarities between our results and the authors's original ones. However, there are significant statistical differences between them (p < or = 0.01).
Our conclusion is that these criteria have a low diagnostic value in the isolated interpretation of patients with left ventricular hypertrophy, and we need to integrate them with the whole medical history and physical examination.
由于左心室质量与普通人群心血管疾病发病和死亡风险增加相关，且心电图是诊断左心室肥厚的一种便捷且经济的方法，我们决定计算5种心电图诊断左心室肥厚标准的敏感性和特异性，并将原作者的结果与我们的结果进行比较。
对135例患者进行了评估；46例患者因以下标准被排除：慢性阻塞性肺疾病、完全性左或右束支传导阻滞、心血管缺血性疾病或预激综合征。89例患者留存并接受了心电图检查，采用以下标准：Romhilt-Estes积分系统、Sokolow-Lyon标准（SV1+RV5或V6>3.5mV）及（RaVL>1.1mV）、Cornell标准和Rodríguez Padial标准。左心室肥厚根据宾夕法尼亚会议标准定义。
在我们的研究中得到了以下结果：a）Romhilt-Estes标准的敏感性为12%，特异性为87%；b）Sokolow-Lyon标准（SV1+RV5或V6）的敏感性为22%，特异性为79%；c）Sokolow-Lyon标准（RaVL）的敏感性为18%，特异性为92%；d）Cornell标准的敏感性为31%，特异性为87%；e）Rodríguez Padial标准的敏感性为82%，特异性为8%。我们的结果与原作者的结果存在相似之处。然而，它们之间存在显著的统计学差异（p≤0.01）。
我们的结论是，这些标准在单独解读左心室肥厚患者时诊断价值较低，我们需要将它们与完整的病史和体格检查相结合。
