No abstract

Thirty-three different electrocardiographic criteria for left ventricular hypertrophy have been evaluated in 360 autopsied hearts utilizing a chamber dissection technic. One hundred and sixty hearts had left ventricular hypertrophy, and 200 hearts did not (146 of these were normal, and 54 had right ventricular hypertrophy).The following five electrocardiographic criteria had a sensitivity of 56% but 10.5% to 14.5% false positives: Svi or Sv2 +RV5 '-35 mm, SV +±Rv5 or RV6 > 30 mm, Sv, or SV2 + Rv5 or RV6 > 35 mm, SV2 + RV4 or Rv5 > 35 mm, R + S > 40 mm. A point-score system employing a combination of criteria had a sensitivity of 54%, but lowered the false positives to 3%. The best limb-lead criterion was R aVL > 7.5 which had a sensitivity of 22.5% with only 3.5% false positives. The following criteria had no false positives, but the highest sensitivity was 19%: Svl, 24 mm, R aVL> 11 mm, RI + SI,, > 25 mm, RI > 13 mm, R aVL > 12 mm, RI > 15 mm, R aVL > 13 mm, and S aVR > 14 mm. Overall the precordial lead criteria were considerably more sensitive but less specific than the limb lead criteria. Since only six of the 200 hearts without left ventricular hypertrophy were in persons less than 30 years of age, this is not the major explanation for the high incidence of false positives in the more sensitive voltage criteria. The problems of using voltage criteria alone and the need for new criteria and approaches to the electrocardiographic diagnosis of left ventricular hypertrophy are discussed.

No abstract

We investigated the use of soluble transferrin receptor (sTfR), together with more traditional measurements such as iron, transferrin and ferritin, to assess iron status in 70 adult cystic fibrosis patients. sTfR concentration was measured using particle-enhanced immunonephelometry. We found that 69% of subjects as determined by transferrin saturation had iron deficiency, but only 29% as determined by sTfR and 11% as determined by ferritin. We found a significant correlation between C-reactive protein (CRP) and both ferritin (r = 0.38, P = 0.0001) and transferrin saturation (r = -0.54, P < 0.0001). In addition, because the CRP concentration was elevated in 64% of subjects, we feel that the transferrin saturation was overestimating, and the ferritin underestimating, iron deficiency in these patients. The sTfR concentration, on the other hand, is unaffected by the acute-phase response and was therefore thought to be the most useful test for detecting iron deficiency in this group of patients.