scholarly journals USE OF A CARDIAC ELECTROCARDIOGRAPHY AND TRANSTHORACIC ECHOCARDIOGRAPHY DATABASE TO REDEFINE ECG CRITERIA FOR LEFT VENTRICULAR HYPERTROPHY (THE CREATED-LVH STUDY)

2011 ◽  
Vol 57 (14) ◽  
pp. E2032
Author(s):  
Sanjog Kalra ◽  
Arnold Pinter ◽  
Kamran Ahmad ◽  
Victoria Korley ◽  
Paul Dorian ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Transthoracic Echocardiography ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Ecg Criteria

The Peguero-Lo Presti criteria has the highest diagnostic accuracy for the diagnosis of left ventricular hypertrophy in the elderly

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.A.M Tavares ◽  
N Samesima ◽  
L.A Hajjar ◽  
L.C Godoy ◽  
E.M.P Hirano ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Diagnostic Accuracy ◽  
Ventricular Hypertrophy ◽  
The Elderly ◽  
Left Ventricular ◽  
Accuracy Score ◽  
Increased Sensitivity ◽  
Low Sensitivity ◽  
Ecg Criteria ◽  
Improved Accuracy

Abstract Background Left Ventricular Hypertrophy (LVH) is an independent predictor of mortality and cardiovascular morbidity and the 12-lead ECG is recommended as a universal screening for patients with hypertension. However, the ECG has low sensitivity and there is limited data in patients 70 years or older. The recently published Peguero-Lo Presti (PLP) criteria had improved accuracy compared with other ECG criteria but with very few patients with age ≥70 years included. Purpose To compare the accuracy of the PLP criteria versus the traditional ECG criteria for detecting LVH in patients ≥70 years. Methods Retrospective single-center study. Patients were included if they were 70 years or older and underwent an ECG and echocardiogram (gold standard) less than 180 days apart from jan/2017 to mar/2018. Patients with left or right bundle branch block, non-sinus rhythm or ventricular paced rhythm were excluded. All tracings were independently reviewed by two cardiologists, blinded to the echocardiogram. The PLP criteria was compared against Cornell voltage (CV), Sokolow-Lyon voltage (SL), and Romhilt-Estes 4 and 5 (RE) criteria. LVH was defined as a left ventricular mass index >115 g/m2 in males and >95 g/m2 in females, according to the echocardiogram. McNemar's test, F1 score, and the area under the Receiver Operating Characteristic curves (AUC) were used to compare the diagnostic performance of the tests Results A total of 592 patients were included (mean age 77.5 years, SD: 5.9; 50.8% were women). The PLP criteria had increased sensitivity compared with both the SL and CV criteria (p<0.0001 for both comparisons) and RE5 (p=0.042). PLP also had better specificity than the RE4 criteria (p<0.0001) and the highest F1 accuracy score (Table 1). The AUC of the PLP was significantly higher than the AUC of the CV and RE criteria (0.70 vs 0.66 vs 0.64, respectively, p<0.05) and numerically higher than the SL criteria (AUC=0.67, p=0.311, Figure 1). Conclusion Compared to the traditional ECG criteria for LVH, the PLP criteria had the highest diagnostic accuracy in elderly patients. Figure 1. AUC of the ECG criteira Funding Acknowledgement Type of funding source: None

scholarly journals Performance of Electrocardiographic Criteria for Echocardiographically Diagnosed Left Ventricular Hypertrophy in Chinese Hypertensive Patients

2020 ◽  
Vol 33 (9) ◽  
pp. 831-836 ◽  
Author(s):  
Dian Wang ◽  
Jian-Zhong Xu ◽  
Wei Zhang ◽  
Yi Chen ◽  
Jian Li ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
High Specificity ◽  
Left Ventricular ◽  
Hypertensive Patients ◽  
Receiver Operating Characteristic Curves ◽  
Low Sensitivity ◽  
Ecg Criteria ◽  
Cornell Voltage ◽  
Cornell Product

Abstract BACKGROUND Performance of electrocardiographic (ECG) criteria for echocardiographically diagnosed left ventricular hypertrophy (LVH) in Chinese hypertensive patients is not well known. We investigated the accuracy of various ECG criteria for the diagnosis of the echocardiographic LVH according to the new cutoff values of left ventricular mass (LVM) index (>115 g/m2 for men and >95 g/m2 for women) in Chinese hypertensive patients. METHODS Our study included 702 consecutive hypertensive inpatients including 92 (13.1%) concentric and 121 (17.2%) eccentric LVH on standard echocardiography. Diagnostic accuracy of 7 ECG criteria was evaluated by calculating sensitivity and specificity and by using the receiver operating characteristic curves. RESULTS The ECG criteria for the detection of the echocardiographically defined LVH had a sensitivity of 15%–31.9% and specificity of 91.6%–99.2% overall, 20.7%–43.5% and 91.6%–99.2% concentric, and 7.4%–23.1% and 91.6%–99.2% eccentric. ECG diagnosis of LVH defined as the positive diagnosis of any of 4 ECG criteria including Sokolow–Lyon voltage, Cornell voltage, Cornell product, and RavL voltage had a sensitivity of 54% and specificity of 86.3% overall, 71.7% and 86.3% concentric, and 40.5% and 86.3% eccentric. After adjustment for confounding factors, various ECG criteria were significantly correlated with LVM, with standardized β coefficients from 0.20 to 0.39 (P < 0.001) and the highest coefficient for the Cornell product criterion. CONCLUSIONS All ECG LVH indexes had low sensitivity and high specificity in Chinese hypertensive patients. Combination of 4 or all ECG criteria might improve sensitivity without any loss of specificity.

scholarly journals New Gender-Specific Partition Values for ECG Criteria of Left Ventricular Hypertrophy

Hypertension ◽  
2004 ◽  
Vol 44 (2) ◽  
pp. 175-179 ◽  
Author(s):  
Khaled Alfakih ◽  
Kevin Walters ◽  
Tim Jones ◽  
John Ridgway ◽  
Alistair S. Hall ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Ecg Criteria ◽  
Gender Specific

scholarly journals Comparison of Various ECG Criteria in the Diagnosis of Left Ventricular Hypertrophy Using Echocardiography as Gold Standard

2020 ◽  
Vol 7 (8) ◽  
pp. 377-380
Author(s):  
Gailin B. Sebastian ◽  
Ish Kalra ◽  
Zameel A ◽  
Farha Ahmed Payyanil Karlath ◽  
Vivek S. Narayan Pillai
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Gold Standard ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Ecg Criteria

Ventricular hypertrophy

ESC CardioMed ◽  
2018 ◽  
pp. 341-345
Author(s):  
Ljuba Bacharova ◽  
Harvey Estes
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Electric Field ◽  
Ventricular Hypertrophy ◽  
Strong Predictor ◽  
Left Ventricular ◽  
Clinical Value ◽  
Functional Measure ◽  
The Individual ◽  
Low Sensitivity ◽  
Ecg Criteria

The term ‘ventricular hypertrophy’ encompasses changes seen in a variety of cardiac pathological processes as well as in some physiological ones. The traditional concept involved in the electrocardiographic (ECG) diagnosis of ventricular hypertrophy assumes that an enlarged ventricular mass generates a stronger electrical field: in left ventricular hypertrophy the resultant electrical forces oriented posteriorly and leftward are augmented, resulting in an increase in amplitude in corresponding leads. An increased contribution of the right ventricle to the electric field enhances anterior and rightward-oriented forces. In spite of multiple attempts to improve the performance of ECG criteria, the classical ECG criteria for ventricular hypertrophies suffer from low sensitivity and questionable specificity. Traditionally, the strongest arguments advanced in favour of continued use of the ECG have been those related to convenience, availability, and low cost; nevertheless, they are inadequate justification for its use. However, the main problem is the effort to estimate the size/dimensions of ventricles by measuring the electric field. Valid justification must emphasize the added clinical value of the unique information provided by the ECG. The electrical information is a strong predictor of future cardiovascular disease and mortality, and the individual ECG abnormalities may be predictive of specific clinical presentations of disease. The anatomical measure of left ventricular hypertrophy by echocardiogram and magnetic resonance imaging, and functional measure by ECG are complementary information, and they are neither contradictory nor competing measures.

Ventricular hypertrophy

ESC CardioMed ◽  
2018 ◽  
pp. 341-345
Author(s):  
Ljuba Bacharova ◽  
Harvey Estes
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Electric Field ◽  
Ventricular Hypertrophy ◽  
Strong Predictor ◽  
Left Ventricular ◽  
Clinical Value ◽  
Functional Measure ◽  
The Individual ◽  
Low Sensitivity ◽  
Ecg Criteria

The term ‘ventricular hypertrophy’ encompasses changes seen in a variety of cardiac pathological processes as well as in some physiological ones. The traditional concept involved in the electrocardiographic (ECG) diagnosis of ventricular hypertrophy assumes that an enlarged ventricular mass generates a stronger electrical field: in left ventricular hypertrophy the resultant electrical forces oriented posteriorly and leftward are augmented, resulting in an increase in amplitude in corresponding leads. An increased contribution of the right ventricle to the electric field enhances anterior and rightward-oriented forces. In spite of multiple attempts to improve the performance of ECG criteria, the classical ECG criteria for ventricular hypertrophies suffer from low sensitivity and questionable specificity. Traditionally, the strongest arguments advanced in favour of continued use of the ECG have been those related to convenience, availability, and low cost; nevertheless, they are inadequate justification for its use. However, the main problem is the effort to estimate the size/dimensions of ventricles by measuring the electric field. Valid justification must emphasize the added clinical value of the unique information provided by the ECG. The electrical information is a strong predictor of future cardiovascular disease and mortality, and the individual ECG abnormalities may be predictive of specific clinical presentations of disease. The anatomical measure of left ventricular hypertrophy by echocardiogram and magnetic resonance imaging, and functional measure by ECG are complementary information, and they are neither contradictory nor competing measures.

scholarly journals Diagnostic Accuracy of Electrocardiographic Criteria for Left Ventricular Hypertrophy in Thalassemia Syndrome

2018 ◽  
Vol 35 (5-6) ◽  
pp. 132-40
Author(s):  
Sudigdo Sastroasmoro ◽  
Deddy Ria Saputra ◽  
Bambang Madiyono ◽  
Ismet N. Oesman ◽  
Sukman Tulus Putra
Keyword(s):  
Child Health ◽  
Left Ventricular Hypertrophy ◽  
Diagnostic Accuracy ◽  
Body Surface ◽  
Gold Standard ◽  
Ventricular Hypertrophy ◽  
Thalassemia Major ◽  
Left Ventricular ◽  
Low Sensitivity ◽  
Ecg Criteria

We compared the diagnostic accuracy of electrocardiographic (ECG) criteria for left ventricular hypertrophy (LVH) in 119 randomly selected from 400 patients with thalassemia major treated at the Department of Child Health, Medical School, University of Indonesia, Jakarta. Echocardiographically derived left ventricular hypertrophy (EchoLVH), both for body surface area (BSA)-indexed and height-indexed, served as the gold standard. There were 57 girls and 62 boys available, ranging in age from 5 to 27 years. ECG criteria for LVH was detected in 23 outof119 patients, while echo-LVH was detected in 47 patients if BSA-indexed LVH was used, or 22 patients if height-indexed LVH was used. The sensitivity and specificity of ECG-LVH were 25.5 and 84.7% respectively if BSA indexed LVH was used as gold standard, or 36.4% and 84.5%, respectively, when height indexed echo-LVH was used. It is concluded that ECG criteria for LVH has a low sensitivity and hjgh specificity in detecting increased left ventricular mass in children with thalassemia major.

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