Author/Editor		Petek-Šter, Marija; Krajačič, Boris
Title		Ocena hipertrofije levega prekata pri bolnikih z esencialno arterijsko hipertenzijo v ambulanti splošne medicine
Translated title		Assessment of left ventricular hypertrophy in patients with essential arterial hypertension in a general practice
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 73, št. 12
Publication year		2004
Volume		str. 889-93
Language		slo
Abstract		Background. The heart is a target organ in arterial hypertension. Echocardiography is the most valuable noninvasive method to assess the left ventricular hypertrophy. Patients with left ventricular hypertrophy constitute a group with high cardiovascular risk. Unfortunately, it is not affordable to all hypertensive patients treated in general practice. ECG still remains the basic method to evaluate the left ventricular hypertrophy. A selection of the most sensitive ECG criteria to evaluate left ventricular hypertrophy might improve the sensitivity of the method and thus recognize a sufficient proportion of the hypertensive patients with left ventricular hypertrophy, confirmed by echocardiography. Patients and methods. We included 62 consecutive patients (31 male and 31 female) with essential arterial hypertension, treated in a single general practice. We made anamnesis, a complete clinical examination with eye fundi examination, usual laboratory examinations, 12-lead ECG and echocardiography. We applied the ECG criteria to evaluate left ventricular hypertrophy (Sokolow Lyon index > 38 mm, Cornell product > 2440 mm*ms) and echocardiographic criteria (left ventricular mass for men at least 125 g/m2 and for women at least 110 g/m2). Results. We found left ventricular hypertrophy in 13 (21.0%) patients by using the combination of both ECG criteria and in 39 (62.9%) by echocardiography. The sensitivity of the combined ECG criteria was 25.6%, the sensitivity of Sokolow-Lyon index was 12.8% and the sensitivity of Cornell product was 17.9%. The specificity of Sokolow-Lyon index was 83%, Cornell product had 78% specificity and the combination of both criteria had specificity of 100%. The left ventricular hypertrophy confirmed by echocardiography was more prevalent in female patients (p = 0.035) and it showed statistically significant correlation with higher values of Sokolow Lyon index and Cornell product (p < 0.0005). (Abstract truncated at 2000 characters).
Summary		Izhodišča. Srce je tarčni organ pri arterijski hipertenziji. Bolniki z ugotovljeno hipertrofijo levega prekata so skupina z velikim srčno žilnim tveganjem. Ehokardiografija je neinvazivna metoda, s katero lahko objektivno ugotovimo prisotnost hipertrofije levega prekata. Ehokardiografija ni dostopna vsem bolnikoim z arterijsko hipertenzijo, ki jih zdravimo v ambulantah splošne medicine, zato EKG v naših razmerah ostaja osnovna metoda za ugotavljanje hipertrofije levega prekata. Z izbiro najobčutljivejših EKG meril za ugotavljanje hipertrofije prekata je mogoče izboljšati občutljivost metode in prepoznati zadovoljiv delež bolnikov z arterijsko hipertenzijo s hipertrofijo levega prekata, ki jo potrdi ehokardiografija. Preiskovanci in metode. V raziskavi je sadelovalo 62 zaporednih bolnikov (31 moških in 3 žensk) z esencialno arterijsko hipertenzijo, ki se zdravijo v eni ambulanti splošne medicine. Pri vseh bolnikih smo poleg anamnestičnih podatkov in kliničnega pregleda, vključno s pregledom očesnega ozadja, izvedli še običajne laboratorijske preiskave, jim posneli 12-kanalni EKG in ehokardiogram srca. Za oceno hipertrofije levega prekata smo uporabili EKG merila (indeks po Sokolowu in Lyonu > 38 mm, Cornellov produkt > 2440 mm*ms) in ehokardiografska merila za hipertrofijo levega prekata (za moške masa levega prekata vsaj 125 g/m2 in za ženske vsaj 110 g/m2). Rezultati. Z elektrokardiogramom smo hipertrofijo levega prekata ob uporabi kombinacije obeh meril ugotovili pri 13 (21,0%) preiskovancih, s pomočjo ehokardiograma pa pri 39 (62,9%). Občutljivost kombinacije elektrokardiografskih meril je bila 25,6%, indeksa po Sokolowu in Lyonu 12,8% in Cornellovega produkta 17,9%. Specifičnost indeksa po Sokolowu in Lyonu je bila 83%, Cornellovega produkta 78%, ob prisotnih obeh EKG merilih za hipertrofijo levega prekata pa je bila specifičnost 100%. (Izvleček skrajšan pri 2000 znakih).
Descriptors		HYPERTENSION HYPERTROPHY, LEFT VENTRICULAR ELECTROCARDIOGRAPHY ECHOCARDIOGRAPHY HEART RATE RISK FACTORS BLOOD GLUCOSE CHOLESTEROL TRIGLYCERIDES BODY MASS INDEX