心电图电压变化与左室肥厚的相关性研究

Relationship between electrocardiographic voltage and left ventricular hypertrophy

目的:探讨心电图电压变化与左室肥厚的关系。方法:根据心电图基线及1年后结果,将90例高血压患者分为3组:Cornell电压增长组(增长≥25%);Cornell电压无变化组(变化<25%)和Cornell电压减少组(减少≥25%),每组30例。观察3组左室质量指数(LVMI)和血压的变化及新发心脑血管事件,并进一步分析电压变化率与LVMI变化率之间的关系。结果:与Cornell电压增长组和无变化组比较,Cornell电压减少组的LVMI绝对值及其变化率最为明显[(-30.3±14.6)g/m2∶(31.1±13.6)g/m2∶(-13.7±24.0)g/m2,(-23.1±7.0)%∶(27.7±10.6)%∶(-9.7±17.4)%,均P<0.01],收缩压、舒张压较基线明显下降,新发心脑血管事件亦最少。电压变化率与LVMI变化率呈正相关(r=0.880,P<0.01)。结论:心电图Cornell电压变化预示着LVMI的相应变化,可作为一种经济、简便的手段应用于左室肥厚患者的随诊和指导临床治疗。

Objective：To explore the relationship between the serial changes of electrocardiographic（ECG） voltage and left ventricular hypertrophy（LVH）.Method：According to the ECG at baseline and after one year,90 subjects were equally divided into three groups： progression of Cornell voltage（group A,≥25% progression）;no significant changes of Cornell voltage（group B,25% changes） and decrease in Cornell voltage（group C,≥25% decrease）.The changes of left ventricular mass index（LVMI）,blood pressure（BP） and new cardiovascular disease（CVD） events were observed.Furthermore,we compared the relationship between the change rates in ECG voltage and LVMI.Result：Compared with patients in group A and B,patients in group C had greatest absolute and percent reductions in LVMI [（-30.3±14.6）g/m2 vs（31.1±13.6）g/m2 vs（-13.7±24.0）g/m2,（-23.1±7.0）% vs（27.7±10.6）% vs（-9.7±17.4）%,all P0.01],greatest decreases in both SBP and DBP,and lowest CVD incidence.Correlation analysis showed that the change rate of Cornell voltage was significantly correlated with the change rate of LVMI（r=0.880,P0.01）.Conclusion：The serial changes of Cornell voltage in ECG can predict the corresponding changes of LVMI.As an economy and simple method,ECG can be used in follow-up and guide clinical treatment in patients with LVH.