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

• Autor(a) principal: Mazzaro, Cléber do Lago [UNIFESP]
• Data de Publicação: 2008
• Outros Autores: Costa, Francisco de Assis [UNIFESP], Bombig, Maria Teresa Nogueira [UNIFESP], Luna Filho, Bráulio [UNIFESP], De Paola, Angelo Amato Vincenzo [UNIFESP], Carvalho, Antonio Carlos [UNIFESP], Costa, William da [UNIFESP], Fonseca, Francisco Antonio Helfenstein [UNIFESP], Póvoa, Rui Manuel dos Santos [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0066-782X2008000400003; http://repositorio.unifesp.br/handle/11600/4346
• topic: Hypertrophy; left ventricular; electrocardiography; echocardiography; Hipertrofia ventricular esquerda; eletrocardiografia; ecocardiografia

BACKGROUND: 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 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/m² 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.