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Heart：提高肥胖患者左室肥厚心电图诊断准确性的方法

2016-09-24 MedSci MedSci原创

左室肥厚肥胖
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研究结果表明根据BMI进行调整的Sokolow–Lyon指数（超重：+4mm；肥胖+8mm）提高了左心室肥厚的诊断准确性。如心电图，在世界范围内，仍然是最广泛使用的作为左心室肥厚的筛查工具，将这一发现运用于临床将带来显著的临床效益。

心电图作为筛查左心室肥厚最常用的工具，但现代社会人们越来越胖，导致当前的诊断标准不敏感。近日，在心脏病领域权威杂志《Heart》上的文章专门介绍了一个简单的调整方法，以提高不同体重患者的心肌肥厚诊断的准确性和这种常用工具的敏感性。

研究共纳入了1295名参与者，其中身体质量指数在17.1–53.3 kg/m2范围之间的821名参与者在试验之初接受心脏磁共振检查测量左心室轴、左室质量和体表12导联心电图以产生应用于Sokolow Lyon标准的调整因子。这一因子在另一队列（n=520，BMI：15.9–63.2 kg/m2）中进行验证。

当研究者匹配左室质量时，结合左室轴线偏移和增加的体重指数导致Sokolow–Lyon指数在超重情况下减少了4 毫米和肥胖状态下减少了8毫米。经过调整后，在最初的队列中，Sokolow–Lyon指数的敏感性增加（超重：从12.8%到30.8%；肥胖：从3.1%到27.2%）到接近正常体重的敏感性水平（37.8%）。在验证队列中取得了相似的结果（在超重参与者中敏感性增加：从8.3%到39.1%；肥胖：从9.4%到25%）再次接近正常体重的敏感性水平（39%）。更重要的是，特异性仍然很好（> 93.1%）。

研究结果表明根据BMI进行调整的Sokolow–Lyon指数（超重：+4mm；肥胖+8mm）提高了左心室肥厚的诊断准确性。如心电图，在世界范围内，仍然是最广泛使用的作为左心室肥厚的筛查工具，将这一发现运用于临床将带来显著的临床效益。

原始出处：

Oliver J Rider,et al. Improvements in ECG accuracy for diagnosis of left ventricular hypertrophy in obesity. Heart. 2016. doi:10.1136/heartjnl-2015-309201

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1905890, encodeId=a3ca190589023, content=<a href='/topic/show?id=34953120e52' target=_blank style='color:#2F92EE;'>#准确性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31207, encryptionId=34953120e52, topicName=准确性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=512a199, createdName=lilianxiang, createdTime=Fri Nov 04 18:13:00 CST 2016, time=2016-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1992885, encodeId=ed571992885ba, content=<a href='/topic/show?id=f68e9158034' target=_blank style='color:#2F92EE;'>#诊断准确性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91580, encryptionId=f68e9158034, topicName=诊断准确性)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/pSGl6CJeZ2PzWxdhCtrvv4U9Q281RV8e0AKmlB5ib93DibbiaRyOzmkCdz5F04cbfX5RGOpG4dOXvuQW1fumibVeBg/132, createdBy=fc342500110, createdName=ms9833124466084992, createdTime=Fri Sep 30 13:13:00 CST 2016, time=2016-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1950962, encodeId=42b81950962d8, content=<a href='/topic/show?id=72078190803' target=_blank style='color:#2F92EE;'>#肥胖患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81908, encryptionId=72078190803, topicName=肥胖患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28b7142, createdName=liuquan, createdTime=Mon Dec 12 11:13:00 CST 2016, time=2016-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139472, encodeId=9a051394e224, content=很好非常有帮助，谢谢。, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160930/IMG57EDFF4739EBF3035.jpg, createdBy=0da11618734, createdName=右脚梅西, createdTime=Mon Oct 03 11:33:00 CST 2016, time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356110, encodeId=1f36135611033, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Sep 26 13:13:00 CST 2016, time=2016-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562385, encodeId=d72e1562385dd, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Sep 26 13:13:00 CST 2016, time=2016-09-26, status=1, ipAttribution=)]
    2016-11-04 lilianxiang

    #准确性#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1905890, encodeId=a3ca190589023, content=<a href='/topic/show?id=34953120e52' target=_blank style='color:#2F92EE;'>#准确性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31207, encryptionId=34953120e52, topicName=准确性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=512a199, createdName=lilianxiang, createdTime=Fri Nov 04 18:13:00 CST 2016, time=2016-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1992885, encodeId=ed571992885ba, content=<a href='/topic/show?id=f68e9158034' target=_blank style='color:#2F92EE;'>#诊断准确性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91580, encryptionId=f68e9158034, topicName=诊断准确性)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/pSGl6CJeZ2PzWxdhCtrvv4U9Q281RV8e0AKmlB5ib93DibbiaRyOzmkCdz5F04cbfX5RGOpG4dOXvuQW1fumibVeBg/132, createdBy=fc342500110, createdName=ms9833124466084992, createdTime=Fri Sep 30 13:13:00 CST 2016, time=2016-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1950962, encodeId=42b81950962d8, content=<a href='/topic/show?id=72078190803' target=_blank style='color:#2F92EE;'>#肥胖患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81908, encryptionId=72078190803, topicName=肥胖患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28b7142, createdName=liuquan, createdTime=Mon Dec 12 11:13:00 CST 2016, time=2016-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139472, encodeId=9a051394e224, content=很好非常有帮助，谢谢。, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160930/IMG57EDFF4739EBF3035.jpg, createdBy=0da11618734, createdName=右脚梅西, createdTime=Mon Oct 03 11:33:00 CST 2016, time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356110, encodeId=1f36135611033, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Sep 26 13:13:00 CST 2016, time=2016-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562385, encodeId=d72e1562385dd, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Sep 26 13:13:00 CST 2016, time=2016-09-26, status=1, ipAttribution=)]
    2016-09-30 ms9833124466084992

    #诊断准确性#

    0

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    2016-12-12 liuquan

    #肥胖患者#

    0

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    2016-10-03 右脚梅西

    很好非常有帮助，谢谢。

    0

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    2016-09-26 zhaojie88

    #ART#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1905890, encodeId=a3ca190589023, content=<a href='/topic/show?id=34953120e52' target=_blank style='color:#2F92EE;'>#准确性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31207, encryptionId=34953120e52, topicName=准确性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=512a199, createdName=lilianxiang, createdTime=Fri Nov 04 18:13:00 CST 2016, time=2016-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1992885, encodeId=ed571992885ba, content=<a href='/topic/show?id=f68e9158034' target=_blank style='color:#2F92EE;'>#诊断准确性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91580, encryptionId=f68e9158034, topicName=诊断准确性)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/pSGl6CJeZ2PzWxdhCtrvv4U9Q281RV8e0AKmlB5ib93DibbiaRyOzmkCdz5F04cbfX5RGOpG4dOXvuQW1fumibVeBg/132, createdBy=fc342500110, createdName=ms9833124466084992, createdTime=Fri Sep 30 13:13:00 CST 2016, time=2016-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1950962, encodeId=42b81950962d8, content=<a href='/topic/show?id=72078190803' target=_blank style='color:#2F92EE;'>#肥胖患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81908, encryptionId=72078190803, topicName=肥胖患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28b7142, createdName=liuquan, createdTime=Mon Dec 12 11:13:00 CST 2016, time=2016-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139472, encodeId=9a051394e224, content=很好非常有帮助，谢谢。, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160930/IMG57EDFF4739EBF3035.jpg, createdBy=0da11618734, createdName=右脚梅西, createdTime=Mon Oct 03 11:33:00 CST 2016, time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356110, encodeId=1f36135611033, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Sep 26 13:13:00 CST 2016, time=2016-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562385, encodeId=d72e1562385dd, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Sep 26 13:13:00 CST 2016, time=2016-09-26, status=1, ipAttribution=)]
    2016-09-26 slcumt

    #HEART#

    0

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