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RESUMEN Introducción: La hipertrofia de ventrículo izquierdo constituye un gran problema entre los pacientes con hipertensión arterial a nivel mundial, además se relaciona con diversas enfermedades, las cuales pueden ser fatales. Objetivo: Evaluar el rendimiento diagnóstico del índice de Sokolow-Lyon en derivaciones precordiales para la hipertrofia de ventrículo izquierdo. Método: Se realizó un estudio de medios diagnósticos de tipo observacional, analítico y transversal. Se estudiaron 122 pacientes ingresados en los servicios de Medicina Interna, Nefrología y Neurología del Hospital Militar Carlos J. Finlay (La Habana, Cuba) de enero del 2017 a marzo del 2019, a los cuales se les realizó ecocardiograma y electrocardiograma. Resultados: Existió un predominio de la población mayor de 45 años (77,9%), del sexo masculino (59,8%) y con hipertensión arterial (77,0%). Se realizó una descripción cualitativa del índice electrocardiográfico de Sokolow-Lyon para precordiales en el total de casos estudiados y se encontró una prevalencia de hipertrofia ventricular izquierda de 71,3%. Este criterio de voltaje presentó una alta especificidad (83%), alto valor predictivos positivo (85%) y una razón de verosimilitud (likelihood ratio) positiva de 2,28. Conclusiones: En pacientes hospitalizados, donde la prevalencia de hipertensión arterial es elevada, el criterio de Sokolow-Lyon presentó alta utilidad diagnóstica para la hipertrofia de ventrículo izquierdo, así como para confirmar los casos que verdaderamente la padecían.
ABSTRACT Introduction: Left ventricular hypertrophy is a major problem among patients with high blood pressure worldwide; it is also related to various entities, which can be fatal. Objective: To evaluate the diagnostic performance of the Sokolow-Lyon index in precordial leads for left ventricular hypertrophy. Method: An observational, analytical and cross-sectional study of diagnostic means was carried out. One hundred and twenty-two patients admitted to the Departments of Internal Medicine, Nephrology and Neurology of the Hospital Militar Carlos J. Finlay (Havana, Cuba) were studied from January 2017 to March 2019, who underwent echocardiography and electrocardiogram. Results: There was a predominance of the population over 45 years old (77.9%), males (59.8%) and with high blood pressure (77.0%). A qualitative description of the Sokolow-Lyon electrocardiographic index for precordial leads was performed in the total number of the studied cases, and a prevalence of 71.3% of left ventricular hypertrophy was found. This voltage criterion showed high specificity (83%), high positive predictive values (85%) and positive likelihood ratio at 2.28. Conclusions: In admitted patients, where the prevalence of high blood pressure is elevated, the Sokolow-Lyon criterion presented high diagnostic usefulness for left ventricular hypertrophy as well as to confirm the cases that actually present it.
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Introduction Left ventricle hypertrophy (LVH) is an important risk factor for cardiovascular morbidity and mortality. It is characterized by a thickening of the walls of the left ventricle. The transthoracic echocardiogram is a very accurate method for LVH detection. However, the electrocardiogram (ECG) offers an alternative method in diagnosing LVH, besides being less expensive and easier to obtain. In this context, this study proposes an ECG based approach for left ventricle hypertrophy (LVH) classification. Methods According to the literature, several indexes have so far been proposed that suggest specific changes in cardiac structure, however, generally speaking there is no consensus about the best criteria. This way, instead of considering only one LVH criterion, a score derived from electrocardiographic traces was employed which explores the complementarity of the best criteria through a fusion strategy. The best criteria are those which discriminate normal and LVH ECGs. Results The experiments were performed in the Monica database with a group of fifty men. Half of the individuals had LVH diagnosed by calculating the left ventricular mass index measured by transthoracic echocardiography. The score fusion proposed achieved a sensitivity of 78.3% and specificity of 91.3%, outperforming all isolated LVH criteria. Discussion Unlike the other methods, our score must be estimated within a computer because of its high complexity. Even with this limitation it is much less expensive than using the echocardiography.
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Objective To explore the susceptibility differences of ventricular arrhythmia (VA ) in SHR rats with/without left ventricular hypertrophy(LVH) and the significance .Methods The experiments were performed on isolated hearts of 8‐week(the non‐LVH control group ,n=12) ,16 week‐old SHR(the LVH group ,n=12) and age‐matched Wistar Kyoto rats(Wistar ,the blank control group ,n=12) ,which were perfused in Langendorff mode with oxygenated Krebs‐Henseleit solution followed by a K+‐defi‐cient solution .The epicardial electrocardiogram was continuously monitored during all experiments .HE staining and collagen vol‐ume fraction(CVF)was used to evaluate the condition of LVH .Results Compared with the non‐LVH control group and the blank control group ,the low K+ induced ventricular arrhythmia occurred earlier with increased incidences and duration in the hearts of the LVH Group ,the incidences of ventricular tachycardia(VT) ,transient ventricular fibrillation(TVF) ,sustained ventricular fibrillation (SVF) and CVF were higher in the hearts of the LVH Group(P<0 .05) ,myocardial cell hypertrophy and myocardial cells intersti‐tial increased .Conclusion The ventricular arrhythmia occurred earlier with increased incidences and duration in the LVH tissue of SHR rats ,which implies that LVH is associated with VA .
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Objective To study the relationship between resting heart rate(RHR)and essential hypertension(EH).Methods 215 patients with EH and 82 healthy subjects underwent RHR detection.The relationship between RHR and the state of EH was analyzed.Results RHR in EH group was significantly higher than that in normal group[(78.9±9.1)bpm vs(69.5±10.9)bpm,P＜0.01)],RHR in different stages of EH was significantly different(F=21.280,P＜0.01,respectively),and increased with grades(P＜0.05 orP＜0.01).RHR in EH patients complicated with left ventricle hypertrophy(LVH)was higher than those with no LVH[(83.9±9.1)bpm vs (75.9±8.9)bpm,P＜0.01].There was positive correlation between RHR and LVH(r=0.8097,P＜0.01).Conclusion RHR is related to the development and progress of EH,and it may be one of the index for estimating the state of EH.
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Objective To evaluate the additional efficiency of aldosterone blockers (AB) during angiotensin Ⅱ receptor blockers (ARB) treatment on hypertensive left ventricle hypertrophy in the elderly. Methods Forty-five cases of hypertensive left ventricular hypertrophy detected by Doppler ultrasonic cardiogram examination were enrolled,and were randomized to receive treatment with ARB plus AB (Group A) or ARB plus diuretics (Group B) for 48 weeks. The indicators of left ventricle hypertrophy were checked before and after the treatment. Results The both regimens could significantly decrease the blood pressure,and there was significant difference in the effects on lowering blood pressure between the regimens. Both regimens could alleviate left ventricle hypertrophy,but the regimen of ARB plus AB was superior to the regimen in Group B. Conclusion The addition of AB treatment during the ARB treatment was a good antihypertensive regimen for reducing left ventricle hypertrophy.
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AIM: To explore the action of Zisheng Qingyang Tablet for improving left ventricle hypertrophy of essential hyertension's traditional Chinese medicine syndromes and for lowering blood pressure(BP). METHODS: There were 60 patients, whose syndrome differentiation typing(SDT) was the yin-deficiency and yang-hyperactivity, the deficiency of heart-qi with dizziness caused by wind accompanied cardiac hypertrophy(essential hypertension left ventricle hypertrophy). The 60 patients were randomly divided into treating group and comtrol group each group with 30 patients. 4 months was one course of treatment. Pre-and post-therapy, the total scores of each group, the individual syndrome's scores of each group and the levels of BP were marked. RESULTS: After treating, the TCM syndromes of two groups were relieved. The total scores and improvements of TCM syndromes were markedly higher than that of the control group, and the significance especially displays on relieving main symptoms, such as dizziness, headache, chest distention and palpitation(P0.05). CONCLUSION: Zisheng Qingyang Table can obviously improve TCM syndromes, The effects especially exist in relieving the main symptoms as follows: dizziness, headache, chest distention, palpitation. The action of Zisheng Qingyang Tablet and captopril for lowering BP is alike.
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AIM To investigate the preventive effects of taurine on the left ventricle hypertrophy in renovascular hypertensive rats. METHODS Two-kidney 1-clip (2K1C) rats were used to establish the model of renovascular hypertension. The myocardial local aldosterone(Ald) and AngⅡconcentration (MDC,MAC) were measured by radioimmunoassay. Expression of oncogene c-fos mRNA was analyzed by means of in situ hybridization. The myocardial collagen concentration (MCC) was measured by biochemical method. The myocardial tissue structure was observed under the microscope ,and the myocardial fiber diamension (MFD) was measured with micrometer. The linear correlation between MCC, MFD and MAC or MDC was analysed respectively. RESULTS Compared with sham operated rats ,the MCC, MAC, MDC and MFD were significantly increased in 2K1C rats ( P