한국인 코호트에서 좌심실 비후를 진단하기 위한 심전도의 정확성 (The Accuracy of Electrocardiogram Criteria for Left Ventricular Hypertrophy in Korean Cohort (Atherosclerosis Risk of a Rural Area Korean General Population))

서지정보

· 발행기관 : 대한고혈압학회
· 수록지 정보 : Clinical Hypertension / 19권 / 4호 / 112 ~ 122페이지
· 저자명 : 안민수, 유병수, 이지현, 이준원, 윤영진, 안성균, 김장영, 이승환, 윤정한, 최경훈, 고상백, 안성복, 박종구

초록

Background: Left ventricular hypertrophy (LVH) offers prognostic information beyond that provided by the evaluation oftraditional cardiovascular risk factors. However, the validation of electrocardiogram (ECG) criteria for the diagnosis of LVH islimited in Korea general population. The purpose of this study is to investigate the diagnostic accuracy of ECG criteria for thedetection of LVH in general population. Methods: In the present study, we investigated a total of 1,946 adults from thecommunity-based cohort. The left ventricular mass index (LVMI) was estimated with echocardiographic measurement andadjusted with body surface area. LVH was defined as a value greater than or equal to the sex-specific 90th percentile value ofLVMI. ECG criteria for the diagnosis of LVH were Sokolow-Lyon criteria and Cornell criteria. Results: The LVMI wassignificantly higher in male subjects (91.1 ± 23.9 g/m2 vs. 83.9 ± 21.7 g/m2, p ＜0.001). The cutoff values were 120.8 g/m2 in malesubjects and 112.2 g/m2 in female subjects. The sensitivity and specificity of Sokolow-Lyon criteria were 5.6% and 93.6% in male,4.1% and 97.8% in female. Those of Cornell criteria were 2.8% and 98.7% in male, 14.3% and 95.8% in female. In male, the areaunder the receiver operating characteristic curves of Sokolow-Lyon voltage and Cornell voltage were 0.55 and 0.52. And those infemale were 0.59 and 0.60. Conclusions: In our community-based sample, ECG criteria showed low sensitivity and high specificity. The performance of ECG criteria for detection of LVH was suboptimal, suggesting limited usefulness of ECG as mass screening tools.

영어초록

Background: Left ventricular hypertrophy (LVH) offers prognostic information beyond that provided by the evaluation oftraditional cardiovascular risk factors. However, the validation of electrocardiogram (ECG) criteria for the diagnosis of LVH islimited in Korea general population. The purpose of this study is to investigate the diagnostic accuracy of ECG criteria for thedetection of LVH in general population. Methods: In the present study, we investigated a total of 1,946 adults from thecommunity-based cohort. The left ventricular mass index (LVMI) was estimated with echocardiographic measurement andadjusted with body surface area. LVH was defined as a value greater than or equal to the sex-specific 90th percentile value ofLVMI. ECG criteria for the diagnosis of LVH were Sokolow-Lyon criteria and Cornell criteria. Results: The LVMI wassignificantly higher in male subjects (91.1 ± 23.9 g/m2 vs. 83.9 ± 21.7 g/m2, p ＜0.001). The cutoff values were 120.8 g/m2 in malesubjects and 112.2 g/m2 in female subjects. The sensitivity and specificity of Sokolow-Lyon criteria were 5.6% and 93.6% in male,4.1% and 97.8% in female. Those of Cornell criteria were 2.8% and 98.7% in male, 14.3% and 95.8% in female. In male, the areaunder the receiver operating characteristic curves of Sokolow-Lyon voltage and Cornell voltage were 0.55 and 0.52. And those infemale were 0.59 and 0.60. Conclusions: In our community-based sample, ECG criteria showed low sensitivity and high specificity. The performance of ECG criteria for detection of LVH was suboptimal, suggesting limited usefulness of ECG as mass screening tools.

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