Combining ECG Criteria for Left Ventricular Hypertrophy Improves Risk Prediction in Patients With Hypertension

Okin, Peter M.; Hille, Darcy A.; Kjeldsen, Sverre E.; Devereux, Richard B.

doi:10.1161/jaha.117.007564

Cited by 45 publications

(31 citation statements)

References 46 publications

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“…Many studies showed that ECG and ECHO LVH predict future adverse outcomes independently and complementarily . Moreover, some studies suggested that combination of Cornell product and Sokolow‐Lyon voltage increased sensitivity for the detection of LVH and coexistence of these two criteria further improved risk prediction for future cardiovascular events and all‐cause mortality . Previous studies usually adopted the most common ECG criteria, such as Cornell voltage/product or Sokolow‐Lyon voltage, whereas in present study we analyzed 18 single established criteria.…”

Section: Discussionmentioning

confidence: 91%

Electrocardiographic criteria for the diagnosis of abnormal hypertensive cardiac phenotypes

Jiang

Quan

Yang

et al. 2019

J of Clinical Hypertension

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This article compared the performance of 18 electrocardiographic (ECG) left ventricular hypertrophic (LVH) criteria and four P‐wave indices for the diagnosis of echocardiographic (ECHO) LVH and left atrial enlargement (LAE), including the deepest S‐wave amplitude added to the S‐wave amplitude of lead V4 (SD+SV4) and P‐wave terminal force in lead V1 (PTFV1). A total of 152 middle‐aged hypertensive patients without evident cardiovascular diseases (CVDs) were enrolled. The gold standard for the diagnosis of LVH and LAE was ECHO left ventricular mass index (LVMI) and largest left atrial volume index (LAVI). For the detection of LVH, Sokolow‐Lyon voltage, Cornell voltage, Cornell product, SD+SV4, Manning, and R+S in any precordial lead had relatively higher sensitivity, especially SD+SV4 criteria. Their combination could further increase sensitivity (43% vs 29% [SD+SV4], P = 0.016). PTFV1 was the only criterion that had significant diagnostic value for ECHO LAE (AUC, 0.68; 95% CI: 0.54‐0.73, P = 0.008). For middle‐aged hypertensive patients without evident cardiovascular diseases, SD+SV4 had the highest sensitivity for the diagnosis of LVH and the combination of several ECG LVH criteria might further increase sensitivity. PTFV1 had significant diagnostic value for ECHO LAE.

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Section: Discussionmentioning

confidence: 91%

Electrocardiographic criteria for the diagnosis of abnormal hypertensive cardiac phenotypes

Jiang

Quan

Yang

et al. 2019

J of Clinical Hypertension

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“…; Okin et al. ). Thus, an increase in PP may be more predictive of cardiovascular risk than either SBP or DBP alone and that ideal antihypertensive therapy should be aimed at rigorous control of both SBP and DBP in order to maintain the PP within in a normal narrow range (Protogerou et al.…”

Section: Discussionmentioning

confidence: 96%

“…The Sokolow‐Lyon voltage criteria (S V1 + R V5/6 ) higher than 38 mm were used to identify LVH (Bacharova and Estes ; Okin et al. ) Echocardiography was done by cardiologists who were blinded to clinical data and ECG findings. Echocardiographic diagnosis of LVH was made based on the left ventricular mass index (LVMI), which was calculated from measurements of interventricular septum thickness, posterior wall thickness of left ventricle, and end‐diastolic left ventricular diameter (Lovic et al.…”

Section: Methodsmentioning

confidence: 99%

“…Thickening of the muscle of the left ventricle (LVH) is the major cardiac complication associated with the progressive pressure overload in hypertension (Okin et al. ). Although adaptive in generating greater forces of contraction, the associated stiffness of the ventricle leads to diminished diastolic compliance and impaired diastolic filling (Masugata et al.…”

Section: Introductionmentioning

confidence: 99%

“…Antihypertensive therapy should therefore be targeted not only at lowering blood pressure, but also at inducing regression or of LVH (Hou and Kang ; Okin et al. ).…”

Section: Introductionmentioning

confidence: 99%

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Regular consumption of green tea improves pulse pressure and induces regression of left ventricular hypertrophy in hypertensive patients

Al-Shafei

El-Gendy

2019

Physiol Rep

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This study characterized the effects of regular green tea ( GT ) and hot water ( HW ) ingestion on systolic blood pressure ( SBP ), diastolic blood pressure ( DBP ), pulse pressure ( PP ), and left ventricular hypertrophy ( LVH ) in two equal, sex‐ and age‐matched groups; Grp1 and Grp2 ( n = 100 each; age 53 ± 4 years) of hypertensive patients. Grp1 had regular GT treatment, followed by HW ingestion, whereas Grp2 had HW ingestion followed by GT treatment for periods of 4 months each. Electrocardiographic ( ECG ) and echocardiographic assessments of LVH were made before and at the end of both periods. SBP was lowered significantly by 6.6%; DBP by 5.1%, and PP by 9.1% by the end of month 4 of GT treatment in Grp1. Upon GT cessation and HW ingestion, SBP , DBP , and PP returned to pretreatment levels over 4 months. In Grp2, SBP , DBP , and PP were reduced insignificantly by 1.5%, 1.0%, and 2.3% by the end of the 4th month of HW ingestion. Conversely, over 4 months of GT treatment, SBP , DBP , and PP were significantly lowered by 5.4%, 4.1%, and 7.7% from the baseline values, respectively. ECG and echocardiographic evidence of LVH was shown in 20% of Grp1 and 24% of Grp2 patients before intervention. This was significantly lowered to 8% and 10% in Grp1 and Grp2 by GT treatment. However, this increased to 16% following HW ingestion in Grp1. HW ingestion did mot induce regression of LVH in Grp2. Thus, regular GT ingestion has cardiovascular protective effects.

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ECG abnormality and predictor of new‐onset atrial fibrillation in hypertension and diabetes mellitus population: An observational analytic study from cardiovascular outpatient clinic at a National Cardiovascular Center in Indonesia

Kikuko,

Julario,

Puspitasari

et al. 2023

Journal of Arrhythmia

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BackgroundPopulation‐based studies have also found that diabetes mellitus (DM) and hypertension (HT) are independent risk factors for atrial fibrillation (AF). However, less is known about new‐onset atrial fibrillation (NOAF) risk factors and its correlation with DM and HT. The aim of this study was to determine the prevalence and pattern of ECG abnormalities, and the predictor of NOAF in patients with HT and DM.MethodsThis cross‐sectional study was conducted at a tertiary hospital from May until December 2021. All medical record data from outpatients who had both diagnoses HT and DM were included in this study. Data from patients with unstable hemodynamics and lack of complete medical record data were excluded. Then, patient history, medical records, ECG, and laboratory information were reviewed.ResultsThere were 162 patients included in this study. Arrhythmia was found in 14.2% of the population, with new‐onset AF (NOAF) as the most common finding with 8.6% incidence, followed by PVC (3.1%) and PAC (2.5%). Bivariate analysis showed that valvular heart disease, random blood glucose, LVEF, and infection status were associated with a higher incidence of NOA. Model from multivariate logistic regression showed that valvular heart disease and random blood glucose level were independently correlated with NOAF (p = .009).ConclusionIt can be concluded that random blood glucose level at a certain point and valvular heart disease can be used as a risk predictor of NOAF in the hypertension population with concomitant DM.

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Combining ECG Criteria for Left Ventricular Hypertrophy Improves Risk Prediction in Patients With Hypertension

Cited by 45 publications

References 46 publications

Electrocardiographic criteria for the diagnosis of abnormal hypertensive cardiac phenotypes

Electrocardiographic criteria for the diagnosis of abnormal hypertensive cardiac phenotypes

Regular consumption of green tea improves pulse pressure and induces regression of left ventricular hypertrophy in hypertensive patients

ECG abnormality and predictor of new‐onset atrial fibrillation in hypertension and diabetes mellitus population: An observational analytic study from cardiovascular outpatient clinic at a National Cardiovascular Center in Indonesia

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