Diagnostic Capability and Influence Factors for a New Electrocardiogram Criterion in the Diagnosis of Left Ventricular Hypertrophy in a Chinese Population

Xia, Yu; Li, Xiaofeng; Zhang, Hao; Liu, Li; Fu, Lijuan; Yan, Wei; Li, Qingxia; Zhang, Yukun; Yu, Miao; Li, Jun; Fang, Pihua

doi:10.1159/000505421

Cited by 4 publications

(3 citation statements)

References 31 publications

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“…Furthermore, in the literature, the comparison between the ECG and the ECHO is a common methodology for the evaluation of electrocardiographic criteria in the diagnosis of LVH. Since the publication of the Peguero-Lo Presti criterion, several studies have been carried out in this way in order to evaluate its performance, including a meta-analysis, whose results were similar to those found in our work [19][20][21][22][23][24][25][26][27].…”

Section: Discussionsupporting

confidence: 75%

Evaluation of Different Criteria in the Diagnosis of Left Ventricular Hypertrophy by Electrocardiogram in Comparison With Echocardiogram

Marcato¹,

Santos²,

Palone³

et al. 2022

Cureus

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Left ventricular hypertrophy (LVH) is an adaptive mechanism of the cardiac muscle due to increased activity demand or functional overload. The echocardiogram (ECHO) presents a better performance in relation to the electrocardiogram (ECG) for the diagnosis of LVH. However, the ECG is a low-cost and easy-to-reproduce diagnostic alternative and can be useful in services and locations where the ECHO is not yet easily accessible.Recently, a new criterion for LVH was proposed by Peguero-Lo Presti. The aim of this article was to evaluate the electrocardiographic criteria for the diagnosis of LVH (Sokolow-Lyon, Cornell voltage, Romhilt-Estes, and Peguero-Lo Presti) in comparison to the diagnosis made by the ECHO.ECHO and ECG from 142 patients' medical records were analyzed. Patients were divided into three groups according to the ECHO -control, eccentric LVH, and concentric LVH. Sensitivity, specificity, PPV, NPV, and accuracy of the four electrocardiographic criteria were evaluated in three scenarios -(1) LVH vs control, (2) concentric LVH vs control, and (3) eccentric LVH vs control.Of the 142 patients included in the study, 100 (70.4%) had LVH. According to the type of hypertrophy, the 100 patients with LVH were divided into two groups -41 (28.8%) had eccentric LVH and 59 (41.5%) had concentric LVH.Of all the scenarios, the Peguero-Lo Presti criteria obtained the best sensitivity (1, 41%; 2, 33,9%; 3, 51,2%) and accuracy (1, 56,3%; 2, 58,4%; 3, 69,8%). The Sokolow-Lyon criteria showed greater specificity in all analyses (100%). None of the electrocardiographic criteria obtained sensitivity values that would justify the use of the electrocardiogram as a screening test for LVH. No differences were found for eccentric and concentric LVH in terms of diagnosis using electrocardiographic criteria. We recommend the use of these criteria to confirm the diagnosis of LVH, especially in low-complexity services that do not have image-based diagnostic tests.

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Section: Discussionsupporting

confidence: 75%

Evaluation of Different Criteria in the Diagnosis of Left Ventricular Hypertrophy by Electrocardiogram in Comparison With Echocardiogram

Marcato¹,

Santos²,

Palone³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…ECG is currently the first requirement in terms of standard recommendations for patients with hypertension owing to its widespread popularity, low cost, and high LVH diagnostic specificity. Despite the progress of innovative ECG diagnostic criteria in recent years, such as the Seamens’ Sign 27 and Peguero–Lo Presti criteria, which improved the sensitivity and accuracy of LVH diagnosis in Chinese populations, 28 the overall sensitivity of ECG diagnosis remains inadequate. In particular, many missed LVH diagnoses remain after completion of ECG examinations.…”

Section: Discussionmentioning

confidence: 99%

Construction and validation of a nomogram to predict left ventricular hypertrophy in low‐risk patients with hypertension

Zhang,

He,

et al. 2024

J of Clinical Hypertension

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Electrocardiography (ECG) is an accessible diagnostic tool for screening patients with hypertensive left ventricular hypertrophy (LVH). However, its diagnostic sensitivity is low, with a high probability of false‐negatives. Thus, this study aimed to establish a clinically useful nomogram to supplement the assessment of LVH in patients with hypertension and without ECG‐LVH based on Cornell product criteria (low‐risk hypertensive population). A cross‐sectional dataset was used for model construction and divided into development (n = 2906) and verification (n = 1447) datasets. A multivariable logistic regression risk model and nomogram were developed after screening for risk factors. Of the 4353 low‐risk hypertensive patients, 673 (15.4%) had LVH diagnosed by echocardiography (Echo‐LVH). Eleven risk factors were identified: hypertension awareness, duration of hypertension, age, sex, high waist‐hip ratio, education level, tea consumption, hypochloremia, and other ECG‐LVH diagnostic criteria (including Sokolow–Lyon, Sokolow–Lyon products, and Peguero–Lo Presti). For the development and validation datasets, the areas under the curve were 0.724 (sensitivity = 0.606) and 0.700 (sensitivity = 0.663), respectively. After including blood pressure, the areas under the curve were 0.735 (sensitivity = 0.734) and 0.716 (sensitivity = 0.718), respectively. This novel nomogram had a good predictive ability and may be used to assess the Echo‐LVH risk in patients with hypertension and without ECG‐LVH based on Cornell product criteria.

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“…Research by Xia 15 et al pointed out that S D +S v4 standard is superior to Cornell standard and Sokolow–Lyon standard in diagnosing LVH; Shao 16 et al also believed that S D +S v4 standard can be more effective than Cornell standard and Sokolow–Lyon standard. The results of this study showed that the AUC value, sensitivity and specificity of the ROC curved by S D and S D +S v4 were all better than those of the ROC curved by R avL +S v3 , and S v1 +R v5 , the Cornell standard and the Sokolow–Lyon standard, suggesting that S D and S D +S v4 could be used to diagnose elderly patients with essential hypertension and LVH.…”

Section: Discussionmentioning

confidence: 99%

The Diagnostic Value of the Deepest S Wave in 12-Lead Electrocardiogram to Elderly Patients with Essential Hypertension and Left Ventricular Hypertrophy

Ji¹,

Zhang²,

He³

2022

CIA

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Objective This study aims to explore the diagnostic value of the deepest S wave (S D ) in elderly patients with essential hypertension and left ventricular hypertrophy (LVH). Methods A retrospective study was conducted in elderly patients with essential hypertension from October 2020 to December 2021. The 12-lead electrocardiogram (ECG) examination was carried out at the time of admission. Echocardiography was performed to estimate left ventricular mass (LVM) and the left ventricular muscle mass index (LVMI) was adjusted by the body surface area (BSA). The Receiver Operating Characteristic (ROC) curve for diagnosing hypertension with LVH was drawn, the cut-off value was determined according to the Youden index, and the area under the curve (AUC) was calculated. The diagnostic values of S D , S D +S v4 , r avl +S v3 , and S v1 +R v5 were compared. Results The results of S D , S D +S v4 , R avL +S v3 , and S v1 +R v5 in the Study group were 2.03 (1.56–2.57) mV, 3.09 (2.38–3.98) mV, 2.19 (1.46–2.78) mV, and 3.38 (2.67–4.19) mV respectively, which were all higher than those in the Control group [0.93 (0.68–1.23) mV, 1.37 (1.32–2.18) mV, 1.03 (0.68–1.46) mV, and 2.28 (1.67–2.67) mV], P <0.001. Compared with the ROC curved by S D +S v4 , R avL +S v3 , and S v1 +R v5 , the AUC of the ROC curved by S D was [0.887, 95% CI (0.837–0.927)], and the cut-off value was 1.298 with the Sensitivity = 86.03 and Specificity = 86.59 in diagnosing essential hypertension with LVH. In female patients, the AUC of the ROC curved by S D was [0.891, 95% CI (0.841–0.934)], and the cut-off value was 1.304 with the Sensitivity of 89.32% and Specificity of 88.67%, which were all higher than those in male patients [AUC = 0.887, 95% CI (0.828–0.943); cut-off value = 1.288; Sensitivity = 82.12%, and Specificity = 84.22%]. Conclusion ECG can effectively diagnose elderly patients with essential hypertension and LVH and the diagnostic value of S D and S D +S v4 are higher than the current Cornell criteria and Sokolow–Lyon criteria.

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Diagnostic Capability and Influence Factors for a New Electrocardiogram Criterion in the Diagnosis of Left Ventricular Hypertrophy in a Chinese Population

Cited by 4 publications

References 31 publications

Evaluation of Different Criteria in the Diagnosis of Left Ventricular Hypertrophy by Electrocardiogram in Comparison With Echocardiogram

Evaluation of Different Criteria in the Diagnosis of Left Ventricular Hypertrophy by Electrocardiogram in Comparison With Echocardiogram

Construction and validation of a nomogram to predict left ventricular hypertrophy in low‐risk patients with hypertension

The Diagnostic Value of the Deepest S Wave in 12-Lead Electrocardiogram to Elderly Patients with Essential Hypertension and Left Ventricular Hypertrophy

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