Improved sex-specific criteria of left ventricular hypertrophy for clinical and computer interpretation of electrocardiograms: validation with autopsy findings.

Casale, Paul N.; Devereux, Richard B.; Alonso, Daniel R.; Campo, E. Del; Kligfield, Paul

doi:10.1161/01.cir.75.3.565

Cited by 484 publications

(293 citation statements)

References 29 publications

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“…In our study sensitivity and specificity using Cornell Voltage Criteria has been 40.24% and 89.65% respectively, which is similar to study conducted by Casale et al 17 (Sensitivity-42%, Specificity-96%).…”

Section: Discussionsupporting

confidence: 90%

Electrocardiographic and Echocardiographic Evaluation of Left Ventricular Hypertrophy in Hypertensive Patients- A Hospital-Based Study

Singh¹,

Baruah²,

Baruah³

2018

jemds

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BACKGROUND Left ventricular hypertrophy is associated with increased risk of cardiovascular morbidity and mortality, so its early detection is of major importance for initiation of treatment and its reversal by certain antihypertensive drugs like ARB and ACE inhibitors. The commonly employed technique for detection of LVH are echocardiography and electrocardiography. Although, ECG is a costeffective tool to detect LVH, but its reliability is often questioned when compared to Gold Standard Echocardiography.The aim of the study is to determine the electrocardiographic and echocardiographic findings of LVH in hypertensive patients and to find out the sensitivity of electrocardiography in comparison to echocardiography in determining LVH in these patients. MATERIALS AND METHODSThe study is a hospital-based observational study, conducted on 108 Hypertensive patients admitted in Medicine and Geriatrics ward and visited Outpatient Department of Medicine in Gauhati Medical College, Guwahati during the period from August 2016 to July 2017 after considering inclusion and exclusion criteria. Inclusion Criteria-Age more than 12 years with Essential or Secondary Hypertension. Exclusion Criteria-Myocardial ischaemia, cardiomyopathy, valvular heart disease and eccentric hypertrophy and bundle branch block, evidence of MI and arrhythmias on ECG. Clinical and laboratory findings were recorded in preformed proforma. Statistical analysis was performed using Microsoft Excel and GraphPad InStat 3.1 version software. RESULTSThe study included a total of 108 Hypertensive patients, out of which 60 (56%) were males and 48 (44%) were females. 82 (75.92%) had LVH by echocardiography and 37 (34.26%) had LVH by electrocardiography. Sensitivity and specificity of ECG in diagnosing LVH is 40.24% and 86.66% respectively in comparison to echocardiography. Sensitivity is highest for Cornell Voltage criteria (40.24%) and lowest for Sokolow-Lyon index criteria (34.14%). CONCLUSIONOur study shows that echocardiography is undoubtedly a better instrument for determination of Left Ventricular Hypertrophy. The study also reveals the fact that although ECG is a poor screening tool due to its low sensitivity, but because of its high specificity various factors determining LVH may independently effect determination of LVH.

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Section: Discussionsupporting

confidence: 90%

Electrocardiographic and Echocardiographic Evaluation of Left Ventricular Hypertrophy in Hypertensive Patients- A Hospital-Based Study

Singh¹,

Baruah²,

Baruah³

2018

jemds

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“…Electrocardiographic criteria for LVH (ECG-LVH) were either Sokolow-Lyon 27 (SV1+RV5 or V6X3.5 mV) or Cornell sex-specific 28 (SV3+RaVLX2.0 mV in women or 2.8 mV in men). ECG-LVH was established by a single independent observer unaware of other patient data.…”

Section: Electrocardiographymentioning

confidence: 99%

Multivariate associates of QT interval parameters in diabetic patients with arterial hypertension: importance of left ventricular mass and geometric patterns

2003

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The aim of the study was to assess the determinants of increased QT interval parameters in diabetic patients with arterial hypertension and, in particular, the strength of their relationships to echocardiographically derived left ventricular mass (LVM) and geometric patterns. In a cross-sectional study with 289 hypertensive type 2 diabetic outpatients, maximal QT and QT c (heart ratecorrected) intervals, and QT, QT c , and number-of-leadsadjusted QT interval dispersions were manually measured from standard baseline 12-lead ECGs. Electrocardiographic criteria for left ventricular hypertrophy (LVH) were either Sokolow-Lyon or Cornell sex-specific voltages. LVM and geometric patterns were determined by 2D echocardiography. Statistical analyses involved bivariate tests (Mann-Whitney, v 2 , Spearman's correlation coefficients, ANOVA and receiver-operating-characteristic (ROC) curve analyses) and multivariate tests (multiple linear and logistic regressions). QT dispersion measurements showed significant correlations with echocardiographic LVM (r ¼ 0.26-0.27). ROC curves demonstrated a poor isolated predictive performance of all QT parameters for detection of LVH (areas under curve: 0.58-0.59), comparable to that of electrocardiographic voltage criteria. Only patients with concentric hypertrophy had significantly increased QT dispersion (QT d ) when compared to those with normal geometries (64.24 7 21.09 vs 53.20 7 15.35, Po0.05). In multivariate analyses, both electrocardiographic and echocardiographic LVH were independent predictors of increased QT d , as well as only QT d and gender were determinants of LVM. In conclusion, increased QT interval dispersion is associated with LVM and concentric hypertrophy geometric pattern in diabetic hypertensive patients, although in isolation neither QT d nor any QT parameter presents enough predictive performance to be recommended as screening procedures for detection of LVH.

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“…In conclusion, we would like to stress that even the already established criteria (cited by Dr. Oliveira) present unmatching values in relation to sensitivity and specificity in the detection of LVH, according to data of the large studies [1][2][3] .…”

Section: To the Editormentioning

confidence: 94%

“…This can be attributed to several variables that influence the accuracy of certain electrocardiographic criteria of LVH, particularly those that analyze only QRS voltage. Among them we can cite physical biotype, body fat, breast presence and size, age, hypertrophy pattern, etc 1 . The subject is really important, controversial and deserves additional clarifying studies.…”

Section: To the Editormentioning

confidence: 99%

Letters to the editor

1999

Arq. Bras. Cardiol.

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Improved sex-specific criteria of left ventricular hypertrophy for clinical and computer interpretation of electrocardiograms: validation with autopsy findings.

Abstract: In a previous study of 543 patients we developed, using echocardiographic left ventricular mass as the reference standard, two new sets of criteria that improve the electrocardiographic diagnosis of left ventricular hypertrophy (LVH).

Cited by 484 publications

References 29 publications

Electrocardiographic and Echocardiographic Evaluation of Left Ventricular Hypertrophy in Hypertensive Patients- A Hospital-Based Study

Electrocardiographic and Echocardiographic Evaluation of Left Ventricular Hypertrophy in Hypertensive Patients- A Hospital-Based Study

Multivariate associates of QT interval parameters in diabetic patients with arterial hypertension: importance of left ventricular mass and geometric patterns

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