Left ventricular hypertrophy detection from simple clinical measures combined with electrocardiographic criteria in a group of African ancestry

Maunganidze, Fabian; Woodiwiss, Angela J.; Libhaber, Carlos D.; Maseko, Muzi J.; Majane, Olebogeng H.I.; Norton, Gavin R.

doi:10.1007/s00392-014-0730-2

Cited by 7 publications

(6 citation statements)

References 23 publications

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“…(20, 21) Ethnic differences in blood pressure begin to emerge in adolescence and early adulthood. (22–24) The Health Surveys for England showed a crossover in blood pressure (i.e., African-Caribbeans higher than whites) somewhat later, at 30-40 years of age. (25) Even after adjustment for age, body mass index, smoking, and alcohol intake African-Caribbeans still have higher odds of having hypertension.…”

Section: Discussionmentioning

confidence: 99%

Predictors of diastolic dysfunction in ethnic groups: observations from the Hypertensive Cohort of The Ethnic-Echocardiographic Heart of England Screening Study (E-ECHOES)

Shantsila

Gill

et al. 2018

J Hum Hypertens

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The study aimed to establish a relationship of ethnicity to diastolic dysfunction in subjects of African-Caribbean and South Asian origins and the impact of diastolic dysfunction and ethnicity on all-cause and cardiovascular mortality.Hypertensive subjects with ejection fraction ≥55% and no history of ischemic heart disease/valve pathology (n=1546, 830 South Asians and 716 African-Caribbeans) were identified from the Ethnic - Echocardiographic Heart of England Screening Study (E-ECHOES). Diastolic function and cardiac remodelling were measured by echocardiography.African-Caribbean ethnicity was associated with lower prevalence of having diastolic dysfunction (odds ratio 0.67, 95% confidence interval 0.51-0.87, p=0.003) and increased left ventricular filling pressure (odds ratio 0.48, 95% confidence interval 0.34-0.69, p<0.001) as well as lower left atrial index (p<0.001). This was the case despite the fact that African-Caribbean ethnicity was independently associated with higher left ventricular mass index (p<0.001). Ninety-two deaths (6%) occurred during 68±21 months follow up. On Cox regression analysis, South Asian ethnicity (p=0.024) was predictive of all-cause death before adjustment for parameters of diastolic dysfunction, but it was no longer predictive of death after accounting for these variables.South Asian ethnicity is independently associated with worse parameters of diastolic function in hypertension, despite African-Caribbeans having more prominent hypertrophy.

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Section: Discussionmentioning

confidence: 99%

Predictors of diastolic dysfunction in ethnic groups: observations from the Hypertensive Cohort of The Ethnic-Echocardiographic Heart of England Screening Study (E-ECHOES)

Shantsila

Gill

et al. 2018

J Hum Hypertens

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“…The study design has been described previously. 23 -26 Briefly, nuclear families of black African descent with siblings age >16 years were randomly recruited from the South West Township of Johannesburg, South Africa. Of the 1191 participants recruited, in a substudy consisting of 678 participants, 661 had all echocardiographic and ECG data required for the present analysis.…”

Section: Methodsmentioning

confidence: 99%

“…24,25 A standard 12-lead ECG was recorded at 25 mm/s and 1.0 mV/cm. 20,23,24 The R-and S-wave amplitudes in all leads were measured to the nearest 0.05 mV (0.5 mm). QRS duration was measured to the nearest 4 ms. Cornell, Sokolow-Lyon, Gubner-Ungerleider, and Lewis voltage or time-voltage criteria for LVH were calculated using standard formulas that incorporate a sex-specific constant where required.…”

Section: Methodsmentioning

confidence: 99%

Novel Approach to the Detection of Left Ventricular Hypertrophy Using Body Mass Index–Corrected Electrocardiographic Voltage Criteria in a Group of African Ancestry

Robinson

Woodiwiss

Libhaber

et al. 2016

Clinical Cardiology

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Background: Electrocardiographic (ECG) QRS voltages used to generate criteria for left ventricular hypertrophy (LVH) detection are considerably attenuated by obesity. This effect renders the utility of ECG criteria to detect LVH in obese individuals of African ancestry to be of limited value. Hypothesis: A novel approach to correcting QRS voltages for the attenuating effect of body mass index (BMI) will improve the ability of ECG criteria to detect LVH in a group of African descent. Methods: Left ventricular mass was determined from echocardiography in 661 randomly selected participants (43.0% obese) of black African ancestry in South Africa. Results: As compared with Cornell and Sokolow-Lyon voltage criteria, BMI best correlated with R aVL , GubnerUngerleider, and Lewis QRS complex voltages, but these relations were noted only in those with BMI <29 kg/m 2 . Correcting R aVL and Lewis voltages by the difference in the slope of BMI-voltage relations in those with BMI <29 kg/m 2 vs those with BMI ≥29 kg/m 2 showed the greatest performance for LVH detection (uncorrected R aVL : 0.695 ± 0.025, corrected R aVL : 0.733 ± 0.022; P < 0.0001), and also increased the sensitivity (uncorrected R aVL : 30.6%, corrected R aVL : 42.4%; P < 0.0005) with no significant change in specificity (uncorrected R aVL : 86.3%, corrected R aVL : 83.0%; P = 0.28). Conclusions:We offer a novel approach to correcting ECG voltages for the attenuating effects of obesity in individuals of African ancestry, and this improves the performance and sensitivity for LVH detection. IntroductionAs demonstrated in the general community and in several clinical populations, the identification of left ventricular hypertrophy (LVH) adds to cardiovascular risk prediction. 1 -8 Although echocardiography is the reference method for LVH detection, electrocardiography (ECG) is the more widely available and cost-effective approach. Hence, ECG identification of LVH is recommended by all hypertension (HTN) guidelines for routine risk prediction. However, the value of ECG criteria for the detection of LVH in the obese 9 -15 and in those of black African ancestry 16,17

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“…The study has a retrospective design at two centers and a relatively small sample size; this is probably due to being a specialized cardiology center with greater control of cardiovascular risk factors. Despite the relatively small sample size, the various electrocardiography and LVH studies performed use methodologies similar to that of our study 15,26 . Another limitation is that left ventricular mass was estimated using two-dimensional echocardiography, despite recent reports showing the superiority of cardiac magnetic resonance imaging 21 .…”

Section: Limitationsmentioning

confidence: 99%

Diagnostic accuracy of electrocardiographic criteria for left ventricular hypertrophy compared with echocardiographic findings

Cáceres-Acosta,

Castaño-Cifuentes,

Duque-González

et al. 2024

RCCARE

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Introduction:The electrocardiogram (ECG) is a useful initial tool for detecting left ventricular hypertrophy (LVH), despite its low sensitivity. However, there are no data in the Colombian population on the behavior of the different electrocardiographic criteria. Materials and method: A cross-sectional study was carried out in two specialized cardiology centers in Medellín beginning in 2011, in which the ECGs of 51 patients who met the inclusion criteria were analyzed. Six criteria were calculated, including the Peguero-Lo Presti criterion, while LVH was defined based on two-dimensional and M-mode transthoracic echocardiography. Results: Eighteen patients with electrocardiographic LVH criteria confirmed by echocardiography were analyzed and compared with 33 controls. Left ventricular hypertrophy was found more often in older patients and those with arterial hypertension (HTN) and chronic kidney disease. The ROC curves determined that the best criterion for the electrocardiographic diagnosis of LVH identified by echocardiography is the Peguero-Lo Presti criterion (ROC: 0.81). The specificities of all the criteria were 81-93%, with no significant differences between them. Conclusion: The electrocardiographic criterion with the best diagnostic performance in identifying LVH diagnosed by echocardiography is the Peguero-Lo Presti criterion, compared to the traditional criteria used in the evaluated population.

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Left ventricular hypertrophy detection from simple clinical measures combined with electrocardiographic criteria in a group of African ancestry

Abstract: In individuals of African ancestry, a combination of Cornell product criteria and age, BMI and SBP improves classification accuracy of Cornell criteria for LVH and increases those identified as having a high added as compared to lower cardiovascular risk scores.

Cited by 7 publications

References 23 publications

Predictors of diastolic dysfunction in ethnic groups: observations from the Hypertensive Cohort of The Ethnic-Echocardiographic Heart of England Screening Study (E-ECHOES)

Predictors of diastolic dysfunction in ethnic groups: observations from the Hypertensive Cohort of The Ethnic-Echocardiographic Heart of England Screening Study (E-ECHOES)

Novel Approach to the Detection of Left Ventricular Hypertrophy Using Body Mass Index–Corrected Electrocardiographic Voltage Criteria in a Group of African Ancestry

Diagnostic accuracy of electrocardiographic criteria for left ventricular hypertrophy compared with echocardiographic findings

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