Visceral fat level correction of the left ventricular hypertrophy electrocardiographic criteria

Abstract

Background Left ventricular hypertrophy (LVH) is a well‐known risk factor for cardiovascular events. Even though there are many electrocardiographic (ECG) criteria for LVH, they still provide poor performance, especially among obese patients. The aim of this study was to examine whether adding visceral fat to ECG LVH criteria improves accuracy in the diagnosis. Methods One thousand seven hundred twenty two patients were included in the study. All patients underwent a complete physical examination, office blood pressure measurement, analysis of body composition, 12‐lead ECG, and M‐mode two‐dimensional echocardiography. Four standard ECG criteria for LVH were analyzed, including Cornell voltage criteria, Cornell duration criteria, Sokolow–Lyon voltage criteria, and Sokolow–Lyon product criteria. Adjustments of ECG LVH criteria were performed using visceral fat level (VFATL) and BMI. Transthoracic echocardiography was used as a reference method to compare the quality of ECG LVH criteria. Results Multivariate logistic regression models were created and revealed a significant increase of area under curve (AUC) after VFATL and BMI addition to ECG LVH criteria. Improvement of sensitivity at 90% specificity was observed in all created models. The odds ratio (OR) of the analyzed ECG criteria increased after adding VFATL and BMI to the models. Furthermore, ROC curves analysis exposed better characteristics in detecting LVH of VFATL‐adjusted criteria than BMI‐adjusted and unadjusted criteria. Conclusions Adjusting ECG indexes to BMI or VFATL improves the sensitivity of LVH detection. VFATL‐corrected indexes are more sufficiently than BMI‐corrected. After advancements in indexes, both lean and morbidly obese individuals outcomes show a greater prevalence of correct LVH diagnosis.

Nomogram‐based risk assessment model for left ventricular hypertrophy in patients with essential hypertension: Incorporating clinical characteristics and biomarkers

“…Early detection and intervention of LVH in EH patients, an important factor in heart failure with preserved ejection fraction (HFpEF), is essential in improving ventricular remodeling. Different methods, such as electrocardiography, cardiac ultrasound, and magnetic resonance imaging, have different limitations regarding sensitivity, accuracy, and cost in detecting LVH 29–31 . Therefore, accurate, accessible, and stable detection methods remain a clinical need, which has led to accelerated research on circulating biomarkers to assist as early diagnostic tools in LVH.…”

“…Different methods, such as electrocardiography, cardiac ultrasound, and magnetic resonance imaging, have different limitations regarding sensitivity, accuracy, and cost in detecting LVH. 29 , 30 , 31 Therefore, accurate, accessible, and stable detection methods remain a clinical need, which has led to accelerated research on circulating biomarkers to assist as early diagnostic tools in LVH. Beyond the traditional NT‐pro BNP and BNP, novel circulating biomarkers have become an attractive alternative.…”

Expression of soluble ST2 in patients with essential hypertension and its relationship with left ventricular hypertrophy

“…However, both methods require experienced, trained staff and expensive equipment, resulting in high costs. 23 Therefore, accurate, accessible, and low‐cost LVH detection methods remain a clinical need. The molecules in circulating blood are both stable and readily available, making them an excellent method for monitoring physiological and/or pathological conditions.…”

“…Both echocardiography and cardiac magnetic resonance imaging can be used to obtain an accurate picture of cardiac hypertrophy with high specificity and sensitivity. However, both methods require experienced, trained staff and expensive equipment, resulting in high costs 23 . Therefore, accurate, accessible, and low‐cost LVH detection methods remain a clinical need.…”