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Abstrak
” Akurasi Kriteria Elektrokardiografi Hipertrofi Ventrikel Kiri Voltase
Membedakan Jenis Geometri Hipertrofi Ventrikel Kiri”
Octo Tumbur, Zainal Safri, Refli Hassan
Divisi Kardiologi
Departemen Ilmu Penyakit Dalam
Fakultas Kedokteran Universitas Sumatera Utara
RSUP.H.Adam Malik Medan
Latar Belakang
Perbedaan jenis geometri hipertrofi ventrikel kiri dikaitkan dengan resiko penyakit kardiovaskular, misalnya penyakit stroke dan mortalitas kardiovaskular dengan concentric remodelling, infark jantung dan mortalitas kardiovaskular dengan eccentric LV, dan hanya infark jantung dengan concentric LV. Ekokardiografi merupakan baku emas (gold standard) bagi menentukan diagnosis hipertrofi ventrikel kiri. Tetapi dengan bantuan kriteria elektrokardiografi hipertrofi ventrikel kiri voltase dapat membedakan jenis geometri hipertrofi ventrikel kiri.
Tujuan :
Mengetahui peranan berbagai kriteria Elektrokardiografi Hipertrofi Ventrikel Kiri Voltase untuk membedakan jenis Geometri Hipertrofi Ventrikel Kiri
Bahan dan Cara :
Penelitian potong lintang (cross sectional) dari bulan Juni hingga November 2015 terhadap 100 pasien di poliklinik dan rawat inap kardiologi, dilakukan anamnesis, pengukuran tinggi badan dan berat badan, indeks massa tubuh (IMT), pemeriksaan elektrokardiografi dan ekokardiografi
Hasil :
Dari 100 pasien penelitian ini diperoleh hasil kriteria EKG hipertrofi ventrikel kiri Sokolow-lyon tidak dipenuhi maka didapatkan geometri ventrikel kiri yang normal dengan sensitivitas 60%, spesifisitas 72.22%, dan akurasi 71%. Untuk jenis geometri eksentrik hipertrofi ventrikel kiri didapatkan bila Cornel Voltase tidak dipenuhi dengan sensitivitas 25% dan spesifisitas 71.88% dan akurasi 55%. Dan untuk jenis geometri konsentrik hipertrofi bila rasio RV6/V5 > 1 dipenuhi dengan sensivitias 55.56%, spesifisitas 56.36% dan akurasi 56%. Bila rasio RV6/V5 > 1 tidak dipenuhi didapatkan jenis geometri konsentrik remodeling hipertrofi dengan sensitivitas 55.56%, spesifisitas 49.45% dan akurasi 50%. Pada penelitian ini juga didapatkan sensitivitas dan spesifisitas kriteria Sokolow-Lyon dengan sensitivitas 72.22% dan spesifisitas 60.00 % untuk hipertrofi ventrikel kiri secara ekokardiografi, kriteria Cornel Voltage dengan sensitivitas 77.78% dan spesifisitas 70.00 % untuk hipertrofi ventrikel kiri secara ekokardiografi, dan kriteria rasio RV6/V5 dengan sensitivitas 51.11% dan spesifisitas 70.00 % untuk hipertrofi ventrikel kiri secara ekokardiografi (tabel 4). Secara keseluruhan sensitivitas dan spesifisitas termasuk lemah
Kesimpulan :
Pada penelitian ini berbagai kriteria elektrokardiografi ventrikel kiri voltase dapat membedakan jenis geometri hipertrofi ventrikel kiri. Kriteria elektrokardiografi hipertrofi kiri voltase yaitu Sokolow-Lyon dan Cornel Voltase lebih sensitivitas dan spesifisitas dibandingkan rasio RV6/V5.
Kata Kunci :
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Abstract
“Accuracy of Electrocardiography Criteria for Left Ventricular Hypertrophy Voltage Distinguishing Geometry type Left Ventricular Hypertrophy”
Octo Tumbur, Zainal Safri, Refli Hassan
Cardiology Division
Internal Medicine Department
Faculty of Medicine University of Sumatera Utara
H. Adam Malik General Hospital Medan
Background
The different types of geometry of left ventricular hypertrophy is associated with risk of cardiovascular disease, such as stroke and cardiovascular mortality with concentric remodeling, myocardial infarction and cardiovascular mortality with eccentric LV, and only with concentric LV cardiac infarction. Echocardiography is the gold standard to determine the diagnosis of left ventricular hypertrophy. But with the help of electrocardiographic left ventricular hypertrophy criteria voltage can distinguish the type of geometry of left ventricular hypertrophy.
Objective :
To find out the role of various criteria Electrocardiography Left Ventricular Hypertrophy Voltage to distinguish the type of geometry of the Left Ventricle Hypertrophy
Materials and Methods :
A cross-sectional study (cross-sectional) from June to November 2015 on 100 patients in the clinic and inpatient cardiology, conducted anamnesis, measuring height and weight, body mass index (BMI), electrocardiography and echocardiography examinations.
Result :
Of the 100 patients this study showed ECG criteria for left ventricular hypertrophy Sokolow-lyon not met then obtained normal left ventricular geometry with a sensitivity of 60%, a specificity of 72.22%, and accuracy 71%. For this type of geometry eccentric left ventricular hypertrophy obtained when Cornel Voltage is not filled with sensitivity 25% and specificity of 71.88% and accuracy of 55%. And for this kind of geometry of concentric hypertrophy when the ratio RV6 / V5> 1 is filled with sensivitias 55.56%, a specificity of 56.36% and accuracy of 56%. When the ratio RV6 / V5> 1 are not met obtained types of geometry concentric hypertrophic remodeling with a sensitivity of 55.56%, a specificity of 49.45% and an accuracy of 50% (Picture 10). In this study also found sensitivity and specificity criteria of Sokolow-Lyon with a sensitivity of 72.22% and a specificity of 60.00% for left ventricular hypertrophy in echocardiography, the criteria Cornel Voltage with a sensitivity of 77.78% and a specificity of 70.00% for left ventricular hypertrophy in echocardiography, and criteria for the ratio RV6 / V5 with a sensitivity of 51.11% and a specificity of 70.00% for left ventricular hypertrophy by echocardiography (Table 4). Overall sensitivity and specificity including weak.
Conclusion :
In this study various criteria electrocardiographic left ventricular geometry voltage can differentiate types of left ventricular hypertrophy geometry. Voltage electrocardiographic criteria of left ventricular hypertrophy that Sokolow-Lyon and Cornell Voltage more sensitivity and specificity than the ratio RV6 / V5.
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