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Objective To explore the application value of routine electrocardiogram in the diagnosis of left ventricular hypertrophy (LVH) in hypertensive patients using different configuration diagnostic criteria. Methods The clinical data were collected of 228 patients with essential hypertension treated in Qilu Hospital of Shandong University from September 2016 to March 2021, and the results of echocardiography and electrocardiogram were retrospectively analyzed. Ganau classification of left ventricle was done according to 2018 European Society of Cardiology (ESC)/European Society of Hypertension (ESH) criteria. The patients were divided into normal configuration (NG, n=58) group, concentric remodeling (CR, n=107) group, eccentric hypertrophy (EH, n=24) group and concentric hypertrophy (CH, n=39) group. The classification was done again according to the Echocardiographic Measurements in Normal Chinese Adults (EMINCA) criteria, patients were divided into NG group (n=105), CR group (n=27), EH group (n=81) and CH group (n=15). The consistency of the results of left ventricular configuration classification according to different criteria was compared, and the diagnostic value of ECG in different left ventricular configuration and the difference between groups were analyzed. Results The results of configuration classified according to the 2018 ESC/ESH criteria and EMINCA criteria had statistical difference (P<0.01), and the consistency was poor (Kappa=0.330, P<0.01). According to the 2018 ESC/ESH criteria, the positive rate of ECG in NG group, CR group, EH group and CH group were 5.2%, 7.5%, 29.2%, and 30.8%, respectively. The differences among groups were statistically significant (P<0.01). The positive rate of EH group or CH group was significantly higher than that in NG group or CR group (P<0.0083). The sensitivity and specificity of ECG in diagnosing LVH were 30.2% and 93.3%, respectively. According to the EMINCA criteria, the positive rate of ECG in diagnosing LVH in NG group, CR group, EH group and CH group were 1.9%, 3.7%, 25.9%, and 40.0% respectively. The differences among groups were statistically significant (P<0.01). The positive rate in EH and CH group was significantly higher than that in in NG group (P<0.0083). The sensitivity and specificity of ECG in diagnosing LVH were 28.1% and 97.7%, respectively. Conclusions 2018 ESC/ESH criteria and EMINCA criteria showed a significant difference in classification of left ventricular configuration. In the two different criteria, ECG has low sensitivity and high specificity in the diagnosis of LVH.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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