左室肥厚各项心电图改变的预后价值

Prognostic Value of Various Criteria for ECG Left Ventricular Hypertrophy

对126例高血压合并在室肥厚病人随访14年,观察20余项心电图改变与心脑血管并发症发生率的关系,评价各项心电图改变的相对危险度(RR).结果发现:单纯电压指标异常不是高血压患者独立的危险因子,其心脑血管并发症的危险性比正常人高,是高血压本身所致,而非高电压引起;有不对称倒置T波、左室劳损、PTFv_1异常、Qv_s≥2mm及多项心电图指标异常者发生心脑血管并发症的危险性,分别为正常人的30.67、14.75、14.73、12.48和11.24倍,矫正血压和电压因素后其危险性仍高,是既独立于血压又独立于电压因素之外的心脑血管并发症的危险因子.

126 hypertensive cases of left ventricular hypertrophy (HT-LVH) were followed up for 14 years to investigate the prognostic value of various criteria for ECG left ventricular hypertrophy. Correlations between 20 items of electrocardiographic abnomalites and cardiocerebrovascular events were studied, and their relative risks.( RR ) were evaluated. LVH based on voltage criteria Only is not an independent risk factor for the hypertensive cases, whose higher incidence of cardiovascular events was ascribed to the coexisting higher-leveled BP, rather than the high voltage. Electrocardiographic manifestations of asymmetrically inverted T wave, ST segment depression, PTFv1 < - 0. 04mm. s, Qv5>2mm and multiple abnormalities in patients with hypertension indicated a risk of cardiovascular events, usually 30. 67, 14. 75, 14. 73, 12. 48 and 11. 24 times respectively higher than that of the normal subjects. After rectification of BP and voltage factor, the risk is still high, with a RR of 6. 55, 2. 99, 3. 19, 2. 32 and 2. 26 respectively, that is the risk factor of cardiocerebrovascular events, independent of BP or voltage factor.