Comparison of the Performance of Three Commonly Used Electrocardiographic Indexes for the Diagnosis of Left Ventricular Hypertrophy in Black Hypertensive Patients with Reduced Kidney Function Managed at a Tertiary Healthcare Hospital: A Post-Hoc Analysis

Abstract

Background: Reduced kidney function in blacks is associated with an increased frequency of left ventricular hypertrophy. Given the unavailability of echocardiography in most developing countries, the diagnostic performance of current ECG indexes needs to be evaluated. Objective: To compare the diagnostic performance of 3 commonly used ECG indexes (Sokolow-Lyon, Cornell voltage and Cornell product) in black hypertensive patients. Methods: Electrocardiography and echocardiography estimated left ventricular mass of 155 consecutive hypertensive patients who participated from January 2012 to January 2013 to an echocardiographic cross-sectional study of left ventricular structure was analyzed to compare Cornell voltage and Cornell product indexes with Sokolow-Lyon voltage index as a reference. Reduced kidney function was defined as eGFR < 60 ml/min/1.730.05 m 2 . ROC curves in relation to LVH diagnosis were used to estimate the sensitivities and specificities of each index. P < 0.05 defined the level of the statistical significance. Results: The sensitivity and specificity were 43% and 85%, 23% and 77% and 26% and 77% for Sokolow-Lyon, Cornell voltage and Cornell product indexes, respectively. However, Sokolow-Lyon index (AUC; 95% CI: 0.64; 0.50 -0.78) How to cite this paper: Lepira, F.B., Mpembe, C.M.B., Mbutiwi, F.I.N., Makulo, J.R., Kayembe, P.K., Kajingulu, K.M., Kintoki, E.V. and M'buyamba-Kabangu, J.R. 106showed better performance than Cornell voltage (0.42; 0.25 -0.59) and Cornell product (0.43; 0.28 -0.59). Sokolow-Lyon index cut-point ≥ 37 mm corresponded to the highest Youden index (39.4% of sensitivity and 92.3% of specificity). Conclusion: Although the overall performance of the 3 ECG indexes versus echocardiography was low, Sokolow-Lyon index performed better than the two other indexes in diagnosing LVH.