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Usefulness of QRS voltage correction by body mass index to improve electrocardiographic detection of left ventricular hypertrophy in patients with systemic hypertension.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2014 Aug 01; Vol. 114 (3), pp. 427-32. Date of Electronic Publication: 2014 May 17. - Publication Year :
- 2014
-
Abstract
- Obesity reduces the accuracy of voltage-based electrocardiographic (ECG) criteria for diagnosis of left ventricular (LV) hypertrophy. We developed a new ECG score for diagnosis of LV hypertrophy, defined either by a typical strain pattern or a product of the Cornell voltage (R wave height in lead aVL plus S wave depth in lead V3) by body mass index >604 mm∙kg/m(2). We examined a population of 2,747 untreated hypertensive subjects (mean age 49 ± 11 years) with good quality ECG and echocardiographic tracings. Several traditional ECG criteria for LV hypertrophy were compared with the new score, with echocardiographic LV mass taken as reference. Among the tested criteria, the highest sensitivity combined with specificity was yielded by the new score (sensitivity 36.1%, 95% confidence interval [CI] 32.9 to 39.4; specificity 90.5%, 95% CI 89.1 to 91.8; and accuracy 73.1%, 95% CI 71.5 to 74.8). Prevalence of ECG LV hypertrophy with the new score was 18%. On the basis of comparisons between areas under the receiver operating characteristic curves, the best performance was achieved by the new score with respect to other ECG criteria for LV hypertrophy (all p <0.0001). In conclusion, correction of Cornell voltage by body mass index as a marker of obesity improves the performance of traditional electrocardiography for diagnosis of LV hypertrophy in patients with hypertension.<br /> (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Diagnosis, Differential
Female
Follow-Up Studies
Humans
Hypertension epidemiology
Hypertension physiopathology
Hypertrophy, Left Ventricular epidemiology
Hypertrophy, Left Ventricular etiology
Italy epidemiology
Male
Middle Aged
Morbidity trends
Obesity complications
Obesity epidemiology
Prospective Studies
ROC Curve
Reproducibility of Results
Survival Rate trends
Body Mass Index
Electrocardiography methods
Hypertension complications
Hypertrophy, Left Ventricular diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 114
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 24934758
- Full Text :
- https://doi.org/10.1016/j.amjcard.2014.05.016