Comparisons of traditional electrocardiographic criteria for left and right ventricular hypertrophy in young Asian women

Abstract

The performance of electrocardiographic (ECG) voltage criteria to identify left and right ventricular hypertrophy (LVH and RVH) in young Asian female adults have not been clarified so far. In a sample of 255 military young female adults, aged 25.2 years on average, echocardiographic LVH was respectively defined as the left ventricular mass (LVM) indexed by body surface area (BSA) (≥88 g/m 2 ) and by height 2.7 (≥41 g/m 2.7 ), and RVH was defined as anterior right ventricular wall thickness >5.2 mm. The performance of ECG voltage criteria for the echocardiographic LVH and RVH were assessed by area under curve (AUC) of receiver operating characteristic (ROC) curve to estimate sensitivity and specificity. For the Sokolow-Lyon (the maximum of SV 1 or SV 2 + RV 5 or RV 6 ) and Cornell (RaVL + SV 3 ) voltage criteria with the LVM/BSA ≥88 g/m 2 , the AUC of ROC curves were 0.66 (95% confidence intervals [CI]: 0.52–0.81, P = .039) and 0.61 (95% CI: 0.44–0.77, P = .18), respectively. For these 2 ECG voltage criteria with the LVM/height 2.7 ≥41 g/m 2.7 , the AUC of ROC curves were 0.64 (95% CI: 0.52–0.75, P = 0.11) and 0.73 (95% CI: 0.61–0.85, P = 0.0074), respectively. The best cut-off points selected for the Sokolow-Lyon and Cornell voltage criteria with echocardiographic LVH in young Asian females were 26 mm and 6 mm, respectively. In contrast, all the AUC of ROC curves were less than 0.60 and not significant according to the Sokolow-Lyon (the maximum of RV1 + SV5 or V6) and Myers’ voltage criteria (eg, the voltage of R wave in V1 and the ratios of R/S in V1, V5 and V6) with echocardiographic RVH. There was a suggestion that the ECG voltage criteria to screen the presence of LVH should be adjusted for the young Asian female adults, and with regard to RVH, the ECG voltage criteria were found ineffective.

Electrocardiographic and echocardiographic predictors of greater carotid intima‐media thickness in tactical athletes: The CHIEF atherosclerosis study

“…The highest 5% of the LVM controlled for the body height (m 2.7 ), was 46.0 g/m 2.7 in men (Lin, Fan, et al, 2020; Lin & Liu, 2020; Lin & Lu, 2020) and 38.0 g/m 2.7 in women (Su et al, 2020), which were defined as echocardiographic LVH in this study. The highest 5% of the RV wall thickness was 5.5 mm in men and 5.2 mm in women (Lin, Fan, et al, 2020; Lin& Lu, 2020; Meng et al, 2017; Su et al, 2020) which were defined as echocardiographic RVH in this study.…”

“…The ECG report was interpreted by a board-certified cardiologist. The Cornell voltage criterion for LVH is defined, when (R-aVL + S-V3) ≥18 mm and ≥6 mm respectively for Asian young men and women were met (Su et al, 2017(Su et al, , 2020. ECG-based RVH is defined, when (1) the R/S ratio in V5 or the R/S ratio in V1 > 1, or (2) R-V1 > 6 mm, on the basis of the Myers et al (1948) criteria, or when (R-V1 + S-V5 or S-V6) >10.5 mm according to the Sokolow-Lyon voltage criterion (Sokolow & Lyon, 1949) is fulfilled.…”

Electrocardiographic Machine Learning to Predict Left Ventricular Diastolic Dysfunction in Asian Young Male Adults

“…A conventional 12-lead ECG and a transthoracic echocardiography were also performed to assure their cardiac health for military rank promotions and awards on the same day. The main and ancillary study designs have been described in detail previously [31]- [41].…”

Machine Learning for Electrocardiographic Features to Identify Left Atrial Enlargement in Young Adults: CHIEF Heart Study

“…A population of 2,268 military males aged 17-43 years were obtained from the cardiorespiratory health in eastern armed forces study (CHIEF Heart Study) for the machine learning experiment (32)(33)(34)(35). All the participants received the annual health examination for their demographic, anthropometric, and hemodynamic measurements in the Hualien Armed Forces General Hospital of Taiwan from 2016 to 2021.…”