Titre
Le diagnostic electrocardiographique d'hypertrophie ventriculaire gauche est-il possible en presence d'un hemibloc anterieur? [Is electrocardiographic diagnosis of left ventricular hypertrophy possible in the presence of an anterior hemiblock?]
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Schlapfer, J.
Auteure/Auteur
Jaussi, A.
Auteure/Auteur
Jaeger, M.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
0036-7672
Statut éditorial
Publié
Date de publication
1992-04
Volume
122
Numéro
15
Première page
554
Dernière page/numéro d’article
8
Notes
English Abstract
Journal Article --- Old month value: Apr 11
Journal Article --- Old month value: Apr 11
Résumé
The electrocardiographic diagnosis of left ventricular hypertrophy is often difficult because it is based on a large number of criteria which, even if taken on their own or as "scoring systems", have a poor sensitivity ranging from 10 to 60%. Some authors have shown that the diagnosis is easier--though at first sight this seems paradoxical--in the presence of altered ventricular depolarization. To verify this statement in the case of left anterior fascicular block, we tested the value of six different indices for the detection of left ventricular hypertrophy. We analyzed 100 patients with left anterior fascicular block and compared the six electrocardiographic indices with the echocardiographic reference method, using the formula of the Penn convention, to establish the left ventricular mass. The best index of the six was that of Gertsch: [S3+ (R+S) maximal precordial] greater than or equal to 30 mm. Its sensitivity was 74%, its specificity 69%, its positive predictive value 79% and its negative predictive value 63%. The other tested indices had a sensitivity of less than 45% with a specificity of more than 80%. Furthermore, Gertsch's index was of equal value in confirming the increased left ventricular mass due either to concentric hypertrophy or to dilated cardiomyopathy. This study therefore confirms that electrocardiographic diagnosis of left ventricular hypertrophy is even easier in the presence of left anterior fascicular block than in absence of altered ventricular depolarization. This result is of practical interest, the incidence of left anterior fascicular block being 1 to 5% in the general population and as high as 30% after the age of 80.
Sujets
PID Serval
serval:BIB_14FF31262A3B
PMID
Date de création
2008-01-28T10:53:56.343Z
Date de création dans IRIS
2025-05-20T16:16:18Z