v Abstrak ” Akurasi Kriteria Elektrokardiografi

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 :
Hipertrofi Ventrikel Kiri, EKG, Ekokardiografi, Geometri Hipertrofi Ventrikel Kiri
v
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.
Key Word :
Left ventricular hypertrophy, ECG, Echocardiography, Left ventricular hypertrophy
Geometry
vi