NEW ELECTROCARDIOGRAPHIC CRITERIA FOR DIAGNOSING RIGHT VENTRICULAR HYPERTROPHY IN MITRAL STENOSIS : Comparison with the Bonner's and Mortara's Criteria

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New criteria for the diagnosis of right ventricular hypertrophy (RVH) using a point scoring system were developed after analyzing standard 12-lead ECGs in 155 patients with mitral stenosis verified by cardiac catheterization and 155 age and sex-matched apparently normal healthy subjects. ECGs were evaluated to identify criteria that provided maximum sensitivity and at least a 95% specificity: (1) the R wave magnitude in V_1 had to be > 0.7 mV; (2) the S wave magnitude in V_6 had to be > 0.3 mV; (3) the S wave magnitude in V_1 < 0.5 mV; (4) the R wave magnitude in V_1 plus the S wave magnitude in V_6 minus the S wave magnitude in V_1 must be > 0 mV; and (5) the degree of frontal QRS axis had to be > 90°. Application of these criteria achieved 25% (39 of 155) sensitivity in patients with RVH, significantly better (p < 0.01) than the 17% sensitivity (17 of 155) of Bonner's criteria for the automated ECG. The specificity of the proposed criteria was 98% (152 of 155), significantly better (p < 0.01) than the 90% specificity (139 of 155) of Mortara's criteria. Thus, it was evident that the accuracy of the proposed criteria was the highest among those criteria used in a point scoring system including the currently used automated ECG criteria for the diagnosis of RVH.
1988-10-20