PDF(Sci-hub)
Abstract：
OBJECTIVE: To the authors\' knowledge, limited data are available regarding the association between Electrocardiogram (ECG) signs of right ventricular hypertrophy (RVH) and pulmonary hypertension (PH) in patients with dilated cardiomyopathy (DCM). We aimed to assess the accuracy of the recommended ECG criteria of RVH for predicting PH in patients with DCM.
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.
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.
摘要：
目的：对于作者的知识，关于扩张型心肌病(DCM)患者右心室肥厚(RVH)的心电图(ECG)征象与肺动脉高压(PH)之间的关联,现有数据有限.我们旨在评估RVH推荐的ECG标准预测DCM患者PH的准确性。
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。
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。
