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Usefulness of the pediatric electrocardiogram in detecting left ventricular hypertrophy: results from the Prospective Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV Infection (P2C2 HIV) multicenter study.

Abstract：

BACKGROUND:A shortcoming of the pediatric electrocardiogram (ECG) appears to be its inability to accurately detect left ventricular hypertrophy (LVH). This study prospectively assesses the usefulness of the pediatric ECG as a screening modality for LVH. METHODS:Concomitant echocardiograms and ECGs from a large cohort of children who were exposed to the human immunodeficiency virus (HIV; uninfected) and children who were infected with HIV were compared. By use of the values of Davignon et al, qualitative determination of LVH and quantitative criteria for LVH (RV6, SV1, RV6+SV1, QV6, and Q(III) >98% for age, R/SV1 <98% for age, and [-]TV6) were compared to body surface area adjusted for left ventricular (LV) mass z score. Results were then stratified according to weight and weight-for-height z scores. New age-adjusted predicted values were then constructed from children of a mixed race who were HIV-uninfected, < or =6 years old, and similarly assessed. RESULTS:The sensitivity rate was <20% for detecting increased LV mass, irrespective of HIV status; the specificity rate was 88% to 92%. The sensitivity rate of the individual criteria ranged from 0 to 35%; the specificity rate was 76% to 99%. Test sensitivities remained low when stratified by weight and weight-for-height z scores. Areas under the receiver operator characteristic curves were between 0.59 and 0.70, also suggesting poor accuracy of the ECG criteria. By use of new age-adjusted predicted values, the sensitivity rate decreased to <17%, and the specificity rate increased to 94% to 100%. CONCLUSION:The ECG is a poor screening tool for identifying LVH in children. Sensitivity is not improved with revision of current criteria.

journal_name

Am Heart J

journal_title

American heart journal

authors

Rivenes SM,Colan SD,Easley KA,Kaplan S,Jenkins KJ,Khan MN,Lai WW,Lipshultz SE,Moodie DS,Starc TJ,Sopko G,Zhang W,Bricker JT,Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV Infection Study Grou

doi

10.1067/mhj.2003.15

subject

Has Abstract

pub_date

2003-04-01 00:00:00

pages

716-23

issue

eissn

0002-8703

issn

1097-6744

pii

S0002870302947241

journal_volume

145

pub_type

杂志文章,多中心研究

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Usefulness of the pediatric electrocardiogram in detecting left ventricular hypertrophy: results from the Prospective Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV Infection (P2C2 HIV) multicenter study.