Assessment of electrocardiographic criteria of left atrial enlargement.
Assessment of electrocardiographic criteria of left atrial enlargement.
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DOI：
10.1177/0218492318768131
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发表时间：
2018-05-01
影响因子：
0.7
通讯作者：
Karim, Musa
中科院分区：
文献类型：
--
作者：
Batra, Mahesh Kumar;Khan, Atif;Karim, Musa
背景左心房扩大被认为是一个可靠的、强有力的、广泛接受的心血管结局指标。超声心动图是测量左心房大小的金标准，但在临床实践中，心电图可以是简单，成本效益高，无创的。本研究以二维超声心动图为金标准，评估已建立的心电图标准对左心房扩大的诊断准确性。方法对2016年9月10日至2017年2月10日连续选择的146例临床检查有呼吸困难、心悸和杂音的患者进行横断面研究。所有患者均行心电图和超声心动图检查。心电图V1导联P波终末负向力>40ms·mm或超声心动图左房内径>40mm者为左房扩大。计算敏感性和特异性以评估诊断准确性。结果以二维超声心动图为金标准，心电图诊断左房增大阳性68例，阴性12例。心电图诊断左房扩大的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为54.4%、57.1%、88.3%、17.4%和54.8%。结论心电图是左房扩大的合理指标。在无法进行超声心动图检查的情况下，心电图可用于诊断左房扩大。
Background Left atrial enlargement is considered to be a robust, strong, and widely acceptable indicator of cardiovascular outcomes. Echocardiography is the gold standard for measurement of left atrial size, but electrocardiography can be simple, cost-effective, and noninvasive in clinical practice. This study was undertaken to assess the diagnostic accuracy of an established electrocardiographic criterion for left atrial enlargement, taking 2-dimensional echocardiography as the gold-standard technique. Methods A cross-sectional study was conducted on 146 consecutively selected patients with the complaints of dyspnea and palpitation and with a murmur detected on clinical examination, from September 10, 2016 to February 10, 2017. Electrocardiography and echocardiography were performed in all patients. Patients with a negative P wave terminal force in lead V1>40ms·mm on electrocardiography or left atrial dimension>40mm on echocardiography were classified as having left atrial enlargement. Sensitivity and specificity were calculated to assess the diagnostic accuracy. Results Taking 2-dimensional echocardiography as the gold-standard technique, electrocardiography correctly diagnosed 68 patients as positive for left atrial enlargement and 12 as negative. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of electrocardiography for left atrial enlargement were 54.4%, 57.1%, 88.3%, 17.4%, and 54.8%, respectively. Conclusion The electrocardiogram appears to be a reasonable indicator of left atrial enlargement. In case of nonavailability of echocardiography, electrocardiography can be used for diagnosis of left atrial enlargement.