Abstract:
OBJECTIVES:The object of this study was to assess the hypothesis that the product of QRS voltage and duration, as an approximation of the time-voltage integral of the QRS complex, can improve the electrocardiographic (ECG) identification of left ventricular hypertrophy. BACKGROUND:Electrocardiographic identification of left ventricular hypertrophy has been limited by the poor sensitivity of standard voltage criteria. However, increases in left ventricular mass can be more closely related to increases in the time-voltage integral of the summed left ventricular dipole than to changes in voltage or QRS duration alone. METHODS:Antemortem ECGs were compared with left ventricular mass at autopsy in 220 patients. There were 95 patients with left ventricular hypertrophy, defined by left ventricular mass index > 118 g/m2 in men and > 104 g/m2 in women. The voltage-duration product was calculated as the product of QRS duration and Cornell voltage (Cornell product) and the 12-lead sum of QRS voltage (12-lead product). RESULTS:At partitions with a matched specificity of 95%, each voltage-duration product significantly improved sensitivity for the detection of left ventricular hypertrophy when compared with simple voltage criteria alone (Cornell product 51% [48 of 95] vs. Cornell voltage 36% [34 of 95], p < 0.005 and 12-lead product 45% [43 of 95] vs. 12-lead voltage 31% [30 of 95], p < 0.001). Sensitivity of both the Cornell product and 12-lead product was significantly greater than that found for QRS duration alone (28%, 27 of 95, p < 0.005) and the Romhilt-Estes point score (27%, 26 of 95, p < 0.005), and compared favorably with the sensitivity of the complex Cornell multivariate score (44%, 42 of 95, p = NS). Comparison of receiver operating characteristic curves demonstrated that improved performance of the voltage-duration products for the detection of left ventricular hypertrophy was independent of test partition selection. In addition, test performance of the voltage-duration products was not significantly affected by the presence or absence of a bundle branch block. CONCLUSIONS:These data suggest that the simple product of either Cornell or 12-lead voltage and QRS duration can identify left ventricular hypertrophy more accurately than can voltage or QRS duration criteria alone and may approach or exceed the performance of more complex multiple regression analyses.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Molloy TJ,Okin PM,Devereux RB,Kligfield Pdoi
10.1016/0735-1097(92)90376-xsubject
Has Abstractpub_date
1992-11-01 00:00:00pages
1180-6issue
5eissn
0735-1097issn
1558-3597pii
0735-1097(92)90376-Xjournal_volume
20pub_type
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journal_title:Journal of the American College of Cardiology
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更新日期:2005-08-16 00:00:00
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更新日期:2006-12-05 00:00:00
abstract:OBJECTIVES:We evaluated dobutamine stress electrocardiography for detecting potentially reversible contractile dysfunction or residual ischemia in the infarct-related area. BACKGROUND:ST-T segment changes in pathologic Q wave leads during stress testing may reflect contractile reserve, inducible ischemia or passive me...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/0735-1097(95)00499-8
更新日期:1996-03-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究
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更新日期:2004-06-02 00:00:00
abstract::Long-term variation in the frequency of myocardial ischemia during daily activity in patients with coronary artery disease who do not experience symptomatic changes has not been documented. Because at one point in time, the magnitude of such ischemia is strongly related to the ischemic threshold measured during exerci...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(10)80261-x
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更新日期:1997-09-01 00:00:00
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更新日期:2004-09-15 00:00:00
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更新日期:1990-12-01 00:00:00
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更新日期:2001-04-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2000-02-01 00:00:00
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更新日期:2000-02-01 00:00:00
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更新日期:2004-11-16 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2007-09-04 00:00:00
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更新日期:2013-02-12 00:00:00
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更新日期:2005-06-21 00:00:00
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更新日期:2000-02-01 00:00:00
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更新日期:2000-03-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
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更新日期:1995-03-01 00:00:00
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更新日期:2000-07-01 00:00:00
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更新日期:2018-07-24 00:00:00
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pub_type: 杂志文章
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更新日期:1986-11-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(98)00672-x
更新日期:1999-03-15 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2000-03-01 00:00:00
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更新日期:2005-05-03 00:00:00