Journal article
Performance of new criteria for right ventricular hypertrophy and myocardial infarction in patients with pulmonary hypertension due to cor pulmonale and mitral stenosis
Journal of Electrocardiology, Vol.24(3), pp.231-237
1991
Abstract
Historically, electrocardiographic criteria for right ventricular (RV) hypertrophy has achieved high specificity but low sensitivity. Recently, however, Butler-Leggett et al, have introduced three criteria that attained a 66% sensitivity in a population with RV hypertrophy due to mitral stenosis while maintaining a 95% specificity in an extensive normal control group. Electrocardiographic diagnosis of RV hypertrophy is principally dependent on changes in the QRS complex that may be masked or mimicked by myocardial infarction (MI). This dilemma has been confirmed by documentation of the low specificity of both the Selvester QRS scoring system for MI size estimation (>3 points) and its screening subset (>0 points) in a pure mitral stenosis population. This study introduces the population characterized by RV hypertrophy due to cor pulmonale, which has a mean pulmonary arterial systolic pressure that is higher than the mean for the mitral stenosis population and consequently suggests more severe RV hypertrophy. When compared, the Butler-Leggett criteria for RV hypertrophy are more sensitive in the new population than in the mitral stenosis population (89% versus 60%) and the Selvester QRS scoring system is less specific (12% versus 60%). Three sequential steps are suggested for electrocardiographic analysis: (1) diagnosis of RV hypertrophy using the Butler-Leggett criteria, (2) diagnosis of MI using the Selvester screening criteria in those patients with step 1 negative, and (3) estimation of MI size using the complete Selvester scoring system in patients with step 1 negative and step 2 positive.
Details
- Title
- Performance of new criteria for right ventricular hypertrophy and myocardial infarction in patients with pulmonary hypertension due to cor pulmonale and mitral stenosis
- Authors/Creators
- J.V. Behar (Author/Creator) - Duke UniversityC.M. Howe (Author/Creator) - Duke UniversityN.B. Wagner (Author/Creator) - Duke UniversityS.I. Leggett (Author/Creator) - Duke UniversityT. Hinohara (Author/Creator) - Duke UniversityK.F. Moser (Author/Creator) - University of Texas Health Science Center at DallasC.J. Freye (Author/Creator) - Duke UniversityM.J. Helms (Author/Creator) - Duke UniversityM.G.K. Jones (Author/Creator) - Duke UniversityR.H. Peter (Author/Creator) - Duke UniversityL.J. Rubin (Author/Creator) - University of Maryland, BaltimoreG.S. Wagner (Author/Creator) - Duke University
- Publication Details
- Journal of Electrocardiology, Vol.24(3), pp.231-237
- Publisher
- Elsevier Inc.
- Identifiers
- 991005540848307891
- Copyright
- © 1991 Elsevier Inc.
- Murdoch Affiliation
- Murdoch University
- Language
- English
- Resource Type
- Journal article
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Source: InCites
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- Collaboration types
- Domestic collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.71 Cardiology - Circulation
- 1.71.193 Acute Myocardial Infarction
- Web Of Science research areas
- Cardiac & Cardiovascular Systems
- ESI research areas
- Clinical Medicine