METHODS: According to the definition of PH (mPAP ≥ 25 mm Hg), 35 patients with DCM were divided into 2 groups: DCM with PH (n = 22) and DCM without PH (n = 13). Right heart catheterization was performed in all patients. Seventeen parameters of RVH recommended by the AHA/ACCF/HRS for diagnosis of RVH on ECG were determinded.
RESULTS: The following parameters were correlated with mPAP: RV1 > 6 mm, SV5 > 10 mm, R:SV6 < 0.4, RV1 + SV5 or V6 > 10.5 mm and PII amplitude. The following parameters were significantly different between DCM patients with and without PH: S in V5 (SV5) > 10 mm, S in V6 (SV6) > 3 mm, R:S ratio in V5 (R:SV5) < 0.75, RV1 + SV5 or V6 > 10.5 mm, S > R inI, S > R inII and R:S V1 > R:S V3, although results were no longer significant after correcting for multiple comparisons. High specificity (92.3-100%), lowsensitivity (31.8-50%), high positive predictive value, and low negative predictive value of established parameters of RVH were noted for predicting PH in patients with DCM.
CONCLUSIONS: Several ECG signs of RVH may be useful for in the diagnosis PH in patients with DCM.
方法:根据PH的定义(mPAP≥25mmHg),将35例DCM患者分为2组:合并PH的DCM(n=22)和不合并PH的DCM(n=13)。所有患者均进行了右心导管检查。确定了AHA/ACCF/HRS推荐的RVH诊断心电图RVH的17个参数。
结果:以下参数与mPAP相关:RV1>6mm,SV5>10mm,R:SV6<0.4,RV1+SV5或V6>10.5mm,PII振幅。以下参数在有和无PH的DCM患者之间存在显着差异:V5(SV5)>10mm的S,V6中的S(SV6)>3mm,V5(R:SV5)中的R:S比值<0.75,RV1+SV5或V6>10.5mm,S>RinI,S>RinII和R:SV1>R:SV3,尽管在校正多重比较后结果不再显着。高特异性(92.3-100%),低灵敏度(31.8-50%),高阳性预测值,并注意到RVH已建立的参数对预测DCM患者PH的阴性预测值较低。
结论:RVH的一些ECG征象可能对DCM患者的PH诊断有用。