Sensibilidade do eletrocardiograma na hipertrofia ventricular de acordo com gênero e massa cardíaca
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Data
2013
Autores
Colosimo, Ana Paula [UNIFESP]
Orientadores
Póvoa, Rui Manuel dos Santos [UNIFESP]
Tipo
Dissertação de mestrado
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Introdução: Sabe-se que varios fatores interferem na sensibilidade do Eletrocardiograma (ECG) no diagnostico da Hipertrofia Ventricular Esquerda (HVE), sendo o genero e a massa cardiaca alguns dos principais. O objetivo deste estudo foi avaliar a influencia do sexo na sensibilidade de alguns dos criterios utilizados para a deteccao de HVE, de acordo com a progressao do grau de hipertrofia ventricular. Metodos: Foram estudados 874 pacientes hipertensos do setor de Cardiopatia Hipertensiva da Disciplina de Cardiologia do Hospital São Paulo. Todos foram submetidos a eletrocardiograma de 12 derivacoes e a cocardiograma. De acordo com o genero e com o grau de HVE ao ecocardiograma, os pacientes foram divididos em tres grupos: HVE leve, moderada e grave. Avaliou-se a sensibilidade do ECG para detectar HVE entre homens e mulheres, conforme o grau de HVE. Resultados: Dos 874 pacientes, 265 eram homens (30,3%) e 609 mulheres (69,7%). Os criterios [(S+R)x QRS], Sokolow-Lyon, Romhilt-Estes, Perugia e padrao strain mostraram alto poder discriminatorio no diagnostico de HVE entre homens e mulheres nos tres grupos de HVE, com desempenho superior na populacao masculina e destaque para os escores [(S+R)x QRS] e Perugia. Conclusao: A sensibilidade diagnostica do ECG e maior com o aumento da massa cardiaca. O exame e mais sensivel entre homens, destacando-se os escores [(S+R)x QRS] e Perugia.
Background: Several factors are known to interfere with electrocardiogram (ECG) sensitivity when diagnosing Left Ventricular Hypertrophy (LVH), with gender and cardiac mass being two of the most important ones. Objective: To evaluate the influence of gender on the sensitiv ity of some of the criteria used to detect LVH, according to the progression of ventricular hypertrophy degree. Methods: According to gender and the degree of LVH at the echocardiogram, the patients were divided in three groups: mild, moderate and severe LVH. ECG sensitivity to detect LVH was assessed between men and women, according to the LVH degree. Results: Of the 874 patients, 265 were males (30.3%) and 609, females (69.7%). The [(S + R) X QRS], Sokolow-Lyon, Romhilt-Estes, Perugia and strain criteria showed high discriminatory power in the diagnosis of LVH between men and women in the three groups with LVH, with a superior performance in the male population and highlighting the importance of the [(S + R) X QRS] and Perugia scores. Conclusion: The diagnostic sensitivity of the ECG increases with the cardiac mass. The examination is more sensitive in men, highlighting the importance of the [(S + R) X QRS] and Perugia scores. (Arq Bras Cardiol 2011; 97 (3) : 225-231)
Background: Several factors are known to interfere with electrocardiogram (ECG) sensitivity when diagnosing Left Ventricular Hypertrophy (LVH), with gender and cardiac mass being two of the most important ones. Objective: To evaluate the influence of gender on the sensitiv ity of some of the criteria used to detect LVH, according to the progression of ventricular hypertrophy degree. Methods: According to gender and the degree of LVH at the echocardiogram, the patients were divided in three groups: mild, moderate and severe LVH. ECG sensitivity to detect LVH was assessed between men and women, according to the LVH degree. Results: Of the 874 patients, 265 were males (30.3%) and 609, females (69.7%). The [(S + R) X QRS], Sokolow-Lyon, Romhilt-Estes, Perugia and strain criteria showed high discriminatory power in the diagnosis of LVH between men and women in the three groups with LVH, with a superior performance in the male population and highlighting the importance of the [(S + R) X QRS] and Perugia scores. Conclusion: The diagnostic sensitivity of the ECG increases with the cardiac mass. The examination is more sensitive in men, highlighting the importance of the [(S + R) X QRS] and Perugia scores. (Arq Bras Cardiol 2011; 97 (3) : 225-231)
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Citação
COLOSIMO, Ana Paula. Sensibilidade do Eletrocardiograma na Hipertrofia Ventricular de Acordo com Gênero e Massa Cardíaca. 2013. 80 f. Dissertação (Mestrado em Ciências) – Escola Paulista de Medicina, Universidade Federal de São Paulo. São Paulo, 2013.