THE UTILITY OF CLINICAL, ELECTROCARDIOGRAPHIC, AND ROENTGENOGRAPHIC VARIABLES IN THE PREDICTION OF LEFT-VENTRICULAR FUNCTION
THE UTILITY OF CLINICAL, ELECTROCARDIOGRAPHIC, AND ROENTGENOGRAPHIC VARIABLES IN THE PREDICTION OF LEFT-VENTRICULAR FUNCTION
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DOI：
10.1016/0002-9149(95)80023-l
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发表时间：
1995-02-01
影响因子：
2.8
通讯作者：
GERSH, BJ
中科院分区：
文献类型：
--
作者：
RIHAL, CS;DAVIS, KB;GERSH, BJ
为了确定简单、广泛可用的变量在估计左心室（LV）功能方面的临床价值，我们对入组冠状动脉手术研究登记处的14，507名胸痛患者进行了分析。在这些患者中，4，034例心电图正常，其中91.8%的患者左室射血分数（EF）>0.50，7.6%的患者EF为0.36至0.50，只有0.6%的患者EF小于或等于0.35。T波异常（QRS波群正常）、左束支分支传导阻滞、心电图左心室肥大或心肌梗死、胸部X线片心脏扩大、基底罗音或第三心音的存在显著降低了LVEF正常的可能性。基于这些临床变量，逻辑回归模型的敏感性为68%，特异性为74%，用于识别正常EF湿的受试者。结论是，在胸痛患者中，考虑这些容易获得的临床数据提供了有用的信息，并大大减少了对更昂贵的成像方法的需求。
To determine the clinical value of simple, widely available variables in estimating left ventricular (LV) function, we performed an analysis on 14,507 patients presenting with chest pain who were enrolled in the Coronary Artery Surgery Study registry. Of these patients, 4,034 had a normal electrocardiogram, and of these, 91.8% had an LV election fraction (EF) >0.50, 7.6% had an EF of 0.36 to 0.50, and only 0.6% had an EF less than or equal to 0.35. The presence of T-wave abnormalities (with normal QRS), left bundle branch block, electrocardiographic evidence of LV hypertrophy or myocardial infarction, cardiomegaly on chest roentgenogram, basilar rales, or third heart sound significantly decreased the likelihood of normal LVEF. Based on these clinical variables, a logistic regression model with a sensitivity of 68% and a specificity of 74% for identifying subjects with normal EF wets developed. It was concluded that in patients with chest pain, consideration of such readily available clinical data provides useful information and mar decrease the need for more expensive imaging methods.