在以前健康的年轻患者中,对心电图的右前庭扩大
Lindsey Haack1, Nikkan Das1, Arvind Hoskoppal1
1Department of Pediatric Cardiology, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, PA.
The Journal of pediatrics
|November 2, 2023
概括
电心电图 (ECG) 发现右心房扩大 (RAE) 对年轻患者的回声心电图上真实RAE的积极预测值较低. 一岁以下的婴儿在心电图上有RAE显示出更高的相关性,这表明了进一步测试的具体标准.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 诊断成像 诊断成像 诊断成像
- 临床电生理学 临床电生理学
背景情况:
- 右心房扩大 (RAE) 是儿科患者心脏病的潜在指标.
- 电心电图 (ECG) 是一种常见的初始诊断工具,但其对RAE等特定发现的准确性需要验证.
- 心声图作为评估心室尺寸和形态学的黄金标准.
研究的目的:
- 在以前健康的年轻人中,评估ECG上发现的RAE与通过心声回声图确认的RAE之间的相关性.
- 确定特定的心电图标准,这些标准可能会增加回声心电图上真正RAE的可能性,指导进一步的诊断工作.
主要方法:
- 儿童心脏病学家对162名以前健康的年轻患者进行了回顾性分析,ECG被解释为RAE.
- 心电图在90天内得到心声图,RAE定义为RAz分数>2.2.
- 对RAE和右心室缩的ECG标准进行了审查.
主要成果:
- 在心电图上诊断的RAE对真实RAE的整体积极预测值 (PPV) 低于14%,为14%.
- 在1岁以下的患者中,RAE的PPV明显高 (35%),相比较于年长的儿童 (7%).
- 真正的RAE在心电回声图上与RAE标准在前前导线 (V1-V3) 和右心室缩在心电图上有关.
结论:
- 暗示RAE的心电图发现在一般儿科患者心声图上证实真正的RAE的准确性有限.
- 较年轻的婴儿 (<1岁),前导线 (V1-V3) 中RAE的存在,以及在心电图上出现右心室缩的迹象,都是需要对RAE进行更密切的心声回声评估的指标.
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