Massa ventricular e critérios eletrocardiográficos de hipertrofia: avaliação de um novo escore

Cléber do Lago Mazzaro, Francisco de Assis Costa, Maria Teresa Nogueira Bombig, Bráulio Luna Filho, Ângelo Amato Vincenzo de Paola, Antonio Carlos de Camargo Carvalho, William da Costa, Francisco Antonio Helfenstein Fonseca, Rui Manoel dos Santos Póvoa
2008 Arquivos Brasileiros de Cardiologia  
The left ventricular hypertrophy (LVH) is an important and independent cardiovascular risk factor. There is a scarcity of studies in Brazil designed to test the efficacy of the electrocardiogram (ECG) in the diagnosis of this important pathological process. Objective: To evaluate a new electrocardiographic score for the diagnosis of LVH by ECG: the sum of the highest amplitude of the S wave and the highest amplitude of the R wave on the horizontal plane, multiplied by the result of the QRS
more » ... ult of the QRS duration [(S+R) X QRS)] and comparing it with the classic electrocardiographic criteria. Methods: The echocardiograms and ECG of 1,204 hypertensive patients receiving outpatient care were evaluated. The left ventricular mass index (LVMI) was assessed by the echocardiogram, with a diagnosis of LVH when the LVMI was ≥ 96 g/m2 for women and ≥ 116 g/m 2 for men. Four classic criteria of LVH were analyzed at the ECG, in addition to the new score to be tested. Results: In general, the studied ECG-LVH criteria showed significant statistical correlation to the echocardiographic LVMI. The (R+S) X QRS index, using 2.80 mm.s as the cutoff value, provided test accuracy regarding sensibility and specificity of 35.2% and 88.71%, respectively, representing the best correlation to LVMI (r=0.564) when compared to the other indexes: Romhilt-Estes (r=0.464); Sokolow-Lyon (r=0.419); Cornell voltage (r=0.377); Cornell product r=0.444). Conclusion: All the electrocardiographic criteria used for the assessment of the LV mass presented low sensitivity. The new score presented the best correlation with LVMI when compared to the other indexes. (Arq Bras Cardiol 2008; 90(4): 227-231)
doi:10.1590/s0066-782x2008000400003 pmid:18516381 fatcat:nzljwynen5b4ddcdirrtdeh5la