| Objective Our study would evaluate the diagnosis value of five kinds of ECG voltage criterion,including Sokolow-lyon,Cornell,Guber-Ungerleider,∑QRS,Minnesota code 3.1,in the Chinese hypertensive people with LVH based on LVMI from color Doppler echocardiography,and determine whether Cornell and Sokolow-Lyon criteria identify different groups of patients with LVH,and whether there was a relationship between hypertrophy severity(voltage magnitude criteria)and the prevalence of cardiovascular disease.Subjects and Methods(1)269 hypertensive patients.They were all examined through inquiry history,physical examination laboratory data, chest x-ray,Echocardiography and blood pressure measurement SBP≥140mmHg and/or DBP≥90mmHg(2005 Chinese Guidelines for the Managements of Arterial Hypertension).LVMI measurement process according to American society of echocardiography(ASE)recommending ASE convention,according to Devereux modified formula to calculate LVM(g),while LVMI(g/m~2)=LVM/BSA.LVH criteria:LVMI≥125g/m~2 (male),110g/m~2(female)(2007 European Society of Hypertension).ECG conventional record with each parameter measured from three cardiac cycles and the average value could be obtained.(2)Compared the sensitivity,specificity,accuracy of five kinds of ECG voltage criterion in detecting hypertensive LVH,evaluated the diagnosis value of ECG criteria.(3)Compared characteristics and manifestations of cardiovascular diseases of patients who met Cornell and Sokolow-Lyon criteria,and then the two groups of study population were divided into thirds according to electrocardiographic voltage respectively to enable relationships between hypertrophy severity and cardiovascular disease to be evaluated. (4)statistical analysis of the data was performed using SPSS13.0,P=0.05 was regarded as statistical level.Results(1)The LVMI of positive of reciprocal ECG-LVH had no significant difference(P＞0.05).There were some degree correlation between respective ECG voltage and LVMI.The correlationship between Cornell voltage and LVMI was the best one(r=0.841,P＜0.001).(2) Evaluate the diagnosis value of ECG criterion,including Sokolow-lyon,Cornell,Guber-Ungerleider,∑QRS,Minnesota code 3.1:the sensitivity was:46.6%,72.0%,28.0%,78.3%,33.5%respectively,the specificity was:97.2%,95.4%,99.1%,85.2%,98.1%respectively,the accuracy was: 66.9%,81.4%,56.5%,79.6%,59.5%respectively.(3)The characteristics of patients meeting Cornell criteria are a slightly higher mean age,higher mean BMI,a greater percentage of women and greater prevalence of diabetes mellitus and heart failure.The characteristics of patients who met Sokolow-Lyon criteria were male gender,lower BMI,and lower percentage of diabetes.(4)①Comparison of characteristics of higher group patients versus lower ones who met Sokolow-Lyon criteria showed that the former were slightly younger,more often men,had higher BP levels and less BP control,lower BMI and lower percentages of obesity, diabetes,and abnormal kidney function.②Comparison of characteristics of higher group patients versus lower ones who met Cornell voltage criteria showed that the former were less often controlled patients,had higher SBP and DBP,greater prevalence of diabetes,abnormal kidney function,greater prevalence of heart failure and established cardiovascular disease.③the Logistic model showed that the adjusted odds ratio for the upper versus the lower was 1.65(P=.011)for Sokolow-Lyon criteria,1.59(P=.014)for Cornell criteria.Conclusion(1)The sensitivity and accuracy of Cornell criteria were higher than other criterion,while the specificity of them were similar. It was the much more useful criteria for detecting and diagnosing hypertensive LVH in practice.(2)The demographic characteristics had significant differences between patients defined by Sokolow-lyon and ones defined by Cornell.(3)There was a relationship between the severity of electrocardiographic LVH(voltage magnitude criteria)and the prevalence of established cardiovascular disease.
|
PDF Full Text Request