[Left arterial overload. Electro-echocardiographic correlations].
OBJECTIVE
To compare the accuracy of left atrial enlargement (LAE) diagnosis made by electrocardiographic criteria with those obtained using M-mode echocardiography.


METHODS
We studied 273 patients age 17 to 87 (mean 49) years, 115 men, white 95.5%, black 3.5% mulattos 1%, with or without heart disease of different etiologies. The ECG criteria studied were: a) P terminal force in V1 > or = 0.04 mmx s; b) Pt force in V1 duration > 0.04s; c) Pt force in V1 depth > or = 1 mm; d) P wave notching in D2 with interpeak distance > or = 40ms; f) presence of atrial fibrillation. The gold-standard for LAE was left atrial dimension > 40 mm obtained by echocardiography.


RESULTS
The percentage of correct diagnosis were: atrial fibrillation (88%), Morris index (75%), PtfV1 negativity > or = 1 mm (74%), notched P wave in D2 with interpeak distance > or = 0.04 s (70%), PtfV1 with duration > 0.04 s (64%) and P wave duration in D2 > 0.11s (46%).


CONCLUSIONS
Conventional ECG has limited value for detecting LAE. A higher correlation was found between atrial fibrillation and changes in P wave in V1 and the echocardiographic LAE.
Koehler
N R
NR
Hospital São Lucas, Porto Alegre, RS.
Velho
F J
FJ
Collar
I C
IC
Zouvi
J P
JP
Behr
P B
PB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006332:Cardiomegaly / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
Sobrecarga atrial esquerda. Correlação eletro-ecocardiográfica.