评估戈德伯格三位一体作为充血性心力衰竭的标志物:系统性审查和回顾性研究
Avinash Saraiya1, Julia Yu1, Christina Huang1
1Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Journal of electrocardiology
|October 2, 2023
概括
在目前的实践中,用于检测左心室功能障碍 (LVD) 的戈德伯格三位一体 (GT) 显示出低灵敏度 (2.5%) 和较差的积极预测值 (8%). 这些发现不支持其作为LVD的可靠查工具的使用.
科学领域:
- 心脏病学 心脏病学
- 电心电图是指心电图.
- 诊断工具 诊断工具
背景情况:
- 1982年描述的戈德伯格三位一体 (GT) 是一种心电图 (ECG) 图案,包括高心前QRS电压,低四肢电压和较差的R波进展.
- 这个三位一体最初与左心室功能障碍 (LVD) 相关,报告高灵敏度,特异性和积极预测值 (PPV).
- 随后的研究在复制GT诊断准确性的原始发现时产生了不同的结果.
研究的目的:
- 评估戈德伯格三位一体 (GT) 的当前灵敏度,特异性和PPV,作为左心室功能障碍 (LVD) 的查工具.
主要方法:
- 进行了关于戈德伯格三位一体 (GT) 和左心室功能障碍 (LVD) 的出版文献的系统审查.
- 分析了来自医院数据库 (2017-2022) 的心电图,用于患有低四肢电压和左心室缩 (LVH) 的患者,查GT标准和LVD.
- 在已知的异常性LVD患者中评估GT标准.
主要成果:
- 在8项研究中对11,115名患者进行的系统性审查显示,对GT的敏感性,特异性和PPV高度可变.
- 在医院数据库分析中,在4576名符合条件的ECG中,只有12名符合GT标准;只有1名患者患有LVD,产生8%的PPV.
- 在已确定的LVD患者中,只有40分之一符合GT标准,导致敏感度为2.5%.
结论:
- 文献审查表明,戈德伯格三位一体 (GT) 检测左心室功能障碍 (LVD) 的原始高性能在当前实践中没有得到支持.
- 符合GT标准的心电图在医院数据库中很少出现,PPV低至8%.
- 已知LVD患者的低灵敏度 (2.5%) 进一步表明,GT不是当前时代用于识别LVD的有效工具.
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