Abstract 4130: Applicability Of Left Ventricular Hypertrophy Electrocardiographic Criteria In Professional Athletes

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Nelson Samesima ◽  
Carlos A Pastore ◽  
Luciana D de Matos ◽  
Fernanda F Fumagalli ◽  
Mariane V Ferreira ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Statistical Significance ◽  
False Negative ◽  
Left Ventricular ◽  
False Positives ◽  
Professional Athletes ◽  
Categorical Variables ◽  
S Wave ◽  
S Waves

Introduction. The widely known electrocardiographic criteria for diagnosing left ventricular hypertrophy (LVH) use QRS complex voltages to define whether there is left ventricle enlargement or not. Mild myocardial hypertrophy is detected in many professional athletes and this is a consequence of their daily intensity of training. Thus it is not unusual that athlete’s ECGs show large QRS voltages with normal hearts. Objective. To evaluate the applicability of the usual electrocardiographic criteria for LVH - Sokolow-Lyon, Romhilt-Estes, Cornell and Gubner - in a population of professional athletes. Methods. The four LVH criteria for diagnosing LVH were applied to analyse ECGs of 107 professional athletes (71% soccer players, 29% marathonists, all male, age 25± 10 years, training for 9± 8 years) by the same observer unaware of echocardiographic results. ECG was considered to be indicative of LVH if: Sokolow-Lyon ≥35mm (V 1or 2 S wave+V 5or 6 R wave); Romhilt-Estes score ≥5 points (frontal plane: R or S waves ≥ 20mm, horizontal plane: R or S waves ≥ 30mm, Morris indices, V 5or 6 strain pattern, left axis deviation ≥ − 30°, intrinsecoid deflection ≥ 0.04s, QRS duration ≥ 0.10s) ; Cornell ≥ 28mm (aV L R wave + V 3 S wave); Gubner ≥ 22mm (D I R wave + D III S wave). Hypertrophy was considered whenever: LV diastolic diameter ≥ 60mm and/or septum ≥ 13mm and/or LV posterior wall ≥ 13mm. Kruskal-Wallis was used to statistically analyse quantitative variables, corrected chi-square test for categorical variables. Significance level: p ≤ 0.05. Results. Romhilt-Estes showed the best results (75% sensitivity, 84% specificity, 16 false-positives, 1 false-negative), and was the only criteria with statistical significance (p = 0.047). Sokolow-Lyon showed 100% sensitivity, 15% specificity, p = 0.545, 88% false-positives, 0% false-negative. Cornell and Gubner showed 25% and 0% sensitivity, 95% and 99% specificity, p=0.205 and p = 0.449, respectively. Conclusion. In this male population of professional athletes, Romhilt-Estes score proved to be the best criterion for identifying left ventricular hypertrophy, while Sokolow-Lyon criterion did not discriminate normal from abnormal hearts. Cornell and Gubner criteria should not be used in this population because of their low sensitivity.

scholarly journals Automatic Electrocardiogram Detection of Suspected Hypertrophic Cardiomyopathy: Application to Wearable Heart Monitors

2021 ◽  
Author(s):  
Max Denis ◽  
Mulatu Bachoro ◽  
Winta Gebreslassie ◽  
Timothy Oladunni
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Left Ventricular Hypertrophy ◽  
Healthy Volunteers ◽  
Ventricular Hypertrophy ◽  
Detection Algorithm ◽  
Left Ventricular ◽  
P Value ◽  
S Wave ◽  
Healthy Human ◽  
Total N

In this work, an automatic detection algorithm for hypertrophic cardiomyopathy (HCM) is presented. Of particular interest is the ability of the algorithm to differentiate HCM subjects and healthy volunteers from a single lead ECG dataset. Suspected HCM subjects are identified by the primary clinical abnormality associated with HCM, left ventricular hypertrophy (LVH). In total, n=43 human subjects ECG datasets are investigated: n=21 healthy volunteers and n=22 left ventricular hypertrophy (LVH) patients. Significant differences of p-value 0.01 and 0.04 were found for the respective ECG parameters, S-wave amplitude and ST-segment, when differentiating between the LVH patients and healthy human volunteers.

P1772Diagnostic accuracy of a novel electrocardiographic criterion for the diagnosis of left ventricular hypertrophy in hypertrophic cardiomyopathy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P M Azevedo ◽  
C Guerreiro ◽  
R Ladeiras-Lopes ◽  
R Faria ◽  
N Ferreira ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Left Ventricular Hypertrophy ◽  
Wall Thickness ◽  
Ventricular Hypertrophy ◽  
High Specificity ◽  
Left Ventricular ◽  
S Wave ◽  
Diagnostic Modality ◽  
Maximum Wall Thickness ◽  
Higher Sensitivity

Abstract Introduction The 12-lead electrocardiogram (ECG) is a fundamental initial diagnostic modality for the early evaluation of a patient suspected of having hypertrophic cardiomyopathy (HCM). ECG criteria for the diagnosis of left ventricular hypertrophy (LVH) typically have low sensitivity and high specificity. Recently, a novel ECG criterion (Peguero-Lo Presti, PLP) with higher sensitivity (62%) and similar specificity (90%) was developed in a cohort of hypertensive patients, but its accuracy in patients with HCM has not been tested. We hypothesized that Peguero-Lo Presti criterion would improve upon the sensitivity of other criteria, while maintaining high specificity, for the diagnosis of LVH in patients for with HCM. Methods We retrospectively analyzed 215 consecutive patients who underwent cardiac magnetic resonance (CMR) between 2010 and 2018 for suspected HCM. All patients aged 18 years or older, who had CMR-confirmed HCM and an ECG without confounders (complete left or right bundle brunch block or paced ventricular rhythm) were included for analysis (n=88). Left ventricular mass (LVM) index and maximum wall thickness were derived from CMR analysis. The PLP criteria was defined as the sum of the deepest S wave (SD) in any lead and the S wave amplitude of lead V4 (SV4). Cornell voltage (CL) and Sokolow-Lyon (SL) were used for comparison. We randomly selected 88 gender-matched patients who performed an ECG and CMR for other clinical reasons and who had no structural heart disease or LVH for use as controls. The DeLong and McNemar's test were used to compare ROC area under the curve (AUC) and sensitivity and specificity, respectively, between the three criteria. Results 88 patients with HCM (63% male, mean age 56.7±15 years) were analyzed. The mean maximum wall thickness was 19.9±4.4mm and mean indexed LVM was 89.7±27g/m2. 34 patients (38.6%) had increased indexed LVM and 77 (87.5%) had at least one segment with late gadolinium enhancement (LGE). Discrimination by AUC was highest for PLP (0.85 [95% CI 0.8–0.9]), compared to CL (0.79, p=0.03) and SL (0.73, p=0.02). Using literature cut-offs, the sensitivity of PLP (60% [95% CI 50–70%]) was significantly higher compared to CL (40% [95% CI 30–50%, p<0,001) and SL (41%, [95% CI 31–51%], p=0.01), whilst maintaining high specificity (PLP 96%; CL 98%; SL 94%). After adjusting for LVM, the amount of LGE had a positive correlation with PLP amplitude (Spearman's rho=0.6, coef=2.4, p=0.01), but not Cornell or Sokolow. The sensitivity of PLP was significantly higher than CL and Sokolow in patients with LGE (61% vs 44% vs 43%, p<0.05). Conclusion The Peguero-Lo Presti criteria demonstrated higher sensitivity and similar specificity when compared to the Cornell and Sokolow-Lyon criteria for the diagnosis of LVH in a cohort of patients with hypertrophic cardiomyopathy. Therefore, they could become the standard ECG diagnostic criteria in patients suspected of having LVH and HCM.

scholarly journals Peguero-Lo Presti criteria for the diagnosis of left ventricular hypertrophy: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0246305
Author(s):  
Zongying Yu ◽  
Jie Song ◽  
Li Cheng ◽  
Shasha Li ◽  
Qun Lu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Left Ventricular Hypertrophy ◽  
Diagnostic Accuracy ◽  
Ventricular Hypertrophy ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Cochrane Library ◽  
Bivariate Analysis ◽  
S Wave ◽  
Cornell Voltage

Background The Peguero-Lo Presti criteria are novel electrocardiographic (ECG) diagnostic criteria for the detection of left ventricular hypertrophy (LVH) and represent the sum of the amplitude of the deepest S wave in any lead with the S wave in lead V4 (SD+SV4). The diagnostic efficacy of the Peguero-Lo Presti criteria in LVH is still debatable. We aimed to test the sensitivity and specificity of the Peguero-Lo Presti criteria and compared them with those of the Cornell voltage index to assess their overall performance in LVH diagnosis. Methods Electronic databases (e.g., Medline, Web of Knowledge, Embase, and the Cochrane Library) were searched from their inception until May 18, 2020. Trials written in English that investigated the Peguero-Lo Presti criteria for detecting LVH were included. Data were independently extracted and analyzed by two investigators. Results A total of 51 records were screened, and 6 trials comprising 13,564 patients were finally included. A bivariate analysis showed that the sensitivity of the Peguero-Lo Presti criteria (0.52, 95% confidence interval (CI) 0.46–0.58) was higher than that of the Cornell voltage index (0.29, 95% CI 0.23–0.36) and Sokolow-Lyon criteria (0.24, 95% CI 0.21–0.27); the diagnostic accuracy of the Peguero-Lo Presti criteria (0.69, 95% CI 0.65–0.73) was also higher than that of the Cornell voltage index (0.67, 95% CI 0.62–0.71) and Sokolow-Lyon criteria (0.28, 95% CI 0.25–0.32); and the specificity of the Peguero-Lo Presti criteria (0.85, 95% CI 0.79–0.90) was similar to that of the Cornell voltage index (0.92, 95% CI 0.89–0.95) and Sokolow-Lyon criteria (0.94, 95%CI 0.88–0.97). Two trials (including 12,748 patients) were discharged because they included partly healthy subjects and accounted for substantial heterogeneity. Pooled analysis of the remaining 4 trials (including 816 patients) showed that the sensitivity of the Peguero-Lo Presti criteria (0.56, 95% CI 0.51–0.61) was also higher than that of the Cornell voltage index (0.36, 95% CI 0.31–0.42) and Sokolow-Lyon criteria (0.24, 95% CI 0.18–0.31); the diagnostic accuracy of the Peguero-Lo Presti criteria (0.84, 95% CI 0.80–0.87) was also higher than that of the Cornell voltage index (0.54, 95% CI 0.50–0.58) and Sokolow-Lyon criteria (0.38, 95% CI 0.34–0.42); and the specificity of the Peguero-Lo Presti criteria (0.90, 95% CI 0.87–0.92) was similar to that of the Cornell voltage index (0.93, 95% CI 0.88–0.96) and Sokolow-Lyon criteria (0.97, 95% CI 0.90–0.99). Both the likelihood ratio and posttest probability of the Peguero-Lo Presti criteria and Cornell voltage index were moderate. Conclusion Based on this systematic review and meta-analysis, the Peguero-Lo Presti criteria-based ECG diagnostic method for LVH has high sensitivity, specificity and diagnostic accuracy and should be applied in clinical practice settings.

scholarly journals Peguero – Lo Presti Criteria from Electrocardiography to Diagnose Left Ventricular Hypertrophy in Patients with Hypertension in Adam Malik Hospital

2020 ◽  
Vol 6 (1) ◽  
pp. 29-33
Author(s):  
Masta N. Ginting ◽  
Cut A. Andra ◽  
Ali N. Nasution ◽  
Harris Hasan ◽  
Nizam Z. Akbar ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Strong Predictor ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
S Wave ◽  
Cross Sectional ◽  
Cardiovascular Morbidity And Mortality ◽  
Female Subjects

Background: Left ventricular hypertrophy (LVH) is a preclinical manifestation of cardiovascular disease and a strong predictor of cardiovascular morbidity and mortality. The electrocardiogram (ECG) is an easily available, easy to use and cost effective tool to evaluate LVH. Peguero – Lo Presti criteria is a newcriteria to diagnose LVH from ECG that has higher sensitivity than the other ECG criteria.Aims: To assess the ability of Peguero – Lo Presti criteria to diagnose LVH and obtain new cut-off point criteria to more accurately diagnose LVH in patients with hypertension in Adam Malik Hospital.Methods: A cross sectional study was conducted on patients with hypertension in cardiac centre Adam Malik Hospital Medan. Electrocardiographic examination was performed to obtain Peguero – Lo Presti point in blinded fashion. LVH was assessed using M-mode method with Cube formula. The analysis of Peguero – Lo Presti criteria was based on the calculation of the deepest S wave in any precordial lead (deepest S wave,SD) and S wave in lead V4 (SV4). A SD + SV4 ≥ 28 mm in male and ≥ 23 mm in female subjects were considered positive for LVH. LVH was defined as left ventricular mass index > 115 gr/m2 in male and > 95 gr/m2 in female subjects.Results: Peguero – Lo Presti criteria had 54.8% sensitivity, 97.6% specificity, 55.4% NPV and 97.6% PPV to diagnose LVH. Lowering the cut-off point of Peguero – Lo Presti criteria to 26 mm in male and 22 mm in female subjects improved the sensitivity from 54.8% to 67.1% with 90.5% specificity, 61.3% NPV and 92.5% PPV to diagnose LVH.Conclusion: Peguero – Lo Presti criteria on ECG could be used to diagnose LVH in patients with hypertension in Adam Malik Hospital Medan.

The right heart in cardiac amyloidosis: a comparison between subtypes and with other genetic and non-genetic causes of left ventricular hypertrophy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
G Palmiero ◽  
M Rubino ◽  
E Monda ◽  
M Caiazza ◽  
M.G Trinchillo ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Cardiac Amyloidosis ◽  
Ventricular Hypertrophy ◽  
Systolic Function ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
S Wave ◽  
Roc Curve Analysis ◽  
Right Heart ◽  
Attr Amyloidosis

Abstract Background Right chambers involvement is common in cardiac amyloidosis (CA) but has been ever compared to control groups. Purpose Aim of this study is to compare right heart involvement between CA subgroups (AL vs. ATTR amyloidosis) and between CA and other forms of genetic and non-genetic left ventricular hypertrophy. Methods We enrolled 25 patients with CA (10 pts with AL and 15 pts with wild type ATTR amyloidosis) and 75 patients with LVH (25 HCM pts; 25 HypCMP pts; 25 AS pts). Beside routine echocardiographic measurements, we analysed right chambers dimensions and classical and novel parameters for right ventricular (RV) function [TAPSE (Tricuspid Anulus Plane Systolic Excursion), St (S' wave at RV TDI), global and free-wall strain]. Results ATTR group showed higher right dimensions compared to AL, without differences in RV systolic parameters (see table). CA patients, compared to LVH group, showed no differences in right dimensions. RV systolic parameters were significantly reduced while diastolic Doppler parameters were higher (E/E' 21.7±9.0 vs. 11.2±5.0; p&lt;0.0001). At ROC curve analysis TAPSE showed the best ability in discriminating CA among other forms of LVH (AUC 0.936; 95% CI: 0.879–0.993; p&lt;0.0001), with a sensibility of 94.7% and specificity of 87.3% for a cut-off value of 19.5 mm. At Kaplan-Meier estimation CA patients showed a significantly higher cardiovascular mortality compared to LVH group (9/25 deaths vs. none). At multivariate analysis TAPSE was the only independent prognostic factor (β 1.324; 95% IC: 1.086–1.614; p&lt;0.006). Discussion CA group showed a significantly impaired RV systolic function with higher pulmonary pressures compared to LVH group. TAPSE proved to be the only able to discriminate CA among genetic and non-genetic forms of LVH and also to have prognostic significance. Funding Acknowledgement Type of funding source: None

Left ventricular longitudinal strain in professional athletes, a useful tool to detect an athletes hearts?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Bewarder ◽  
S Kulenthiran ◽  
O Schaefer ◽  
L Lauder ◽  
C Ukena ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Endurance Exercise ◽  
Longitudinal Strain ◽  
Ventricular Hypertrophy ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Soccer Players ◽  
Professional Athletes ◽  
Healthy Controls ◽  
Professional Soccer

Abstract Background Professional cyclists frequently present with physiological adaptations to endurance exercise with an increase in left ventricular wall thickness and mass. Global longitudinal strain (GLS) is an early and sensitive echocardiographic method to detect left ventricular dysfunction. However, it is unclear whether GLS is able to differentiate between athlete's hearts or different pathological conditions of left ventricular hypertrophy. Methods A total of 87 professional athletes (37 professional cyclists, 29 professional soccer players, and 21 professional handball players) were compared to 125 patients with different forms of left ventricular hypertrophy (17 hypertrophic obstructive cardiomyopathy (HOCM), 36 hypertensive heart disease (HHD), 35 severe aortic valve stenosis (AVS); 37 untrained individuals served as controls. Examinations were performed between October 2018 to October 2019. All subjects underwent echocardiographic examination, including GLS. Results In all 212 participants/patients included a preserved ejection fraction &gt;50% (mean 61±7%) was detected. Left ventricular mass index (LVMI) in professional cyclists (165.5±37.1 g/m2) was increased when compared to professional soccer players (97.3±12.4 g/m2, p&lt;0.001), professional handball players (92.2±15.8 g/m2, p&lt;0.001) and healthy controls (94.3±20.7 g/m2, p&lt;0.001), as well as to patients with HHD (129.2±30.0 g/m2, p&lt;0.001), or AVS (140.1±35.4 g/m2, p=0.064), but not to patients with HOCM (159.7±39.4 g/m2, p=0.64). Professional cyclists (−21.0±3.5%) achieved higher average GLS values than professional soccer (−18.4 ± %, p=0.004) or handball players (−18.4 ± %, p=0.021), healthy controls (−19.0±3.0%, p=0.008), HOCM (−15.0±6.5%, p&lt;0.001), HHD (−13.8±5.9%, p&lt;0.001), and AVS (−16.0±7.0%, p&lt;0.001) (Figure 1). Conclusion In professional cyclists, higher LVMI and average GLS values were detected compared to professional soccer and handball players with lower excessive endurance exercise, as well as untrained healthy controls. Average GLS can help to differentiate between athletes' hearts in professional cyclists compared to pathologic patterns in different diseases characterized by left ventricular hypertrophy with elevated LVMI. Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals Electrocardiographic Versus Echocardiographic Left Ventricular Hypertrophy in Severe Aortic Stenosis

2021 ◽  
Vol 10 (11) ◽  
pp. 2362
Author(s):  
Aleksandra Budkiewicz ◽  
Michał A. Surdacki ◽  
Aleksandra Gamrat ◽  
Katarzyna Trojanowicz ◽  
Andrzej Surdacki ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Aortic Stenosis ◽  
Ventricular Hypertrophy ◽  
Severe Aortic Stenosis ◽  
Aortic Pressure ◽  
Left Ventricular ◽  
Receiver Operating Curve ◽  
S Waves ◽  
Prognostic Effect ◽  
Cornell Voltage

Although ECG used to be a traditional method to detect left ventricular hypertrophy (LVH), its importance has decreased over the years and echocardiography has emerged as a routine technique to diagnose LVH. Intriguingly, an independent negative prognostic effect of the “electrical” LVH (i.e., by ECG voltage criteria) beyond echocardiographic LVH was demonstrated both in hypertension and aortic stenosis (AS), the most prevalent heart valve disorder. Our aim was to estimate associations of the ECG-LVH voltage criteria with echocardiographic LVH and indices of AS severity. We retrospectively manually analyzed ECG tracings of 50 patients hospitalized in our center for severe isolated aortic stenosis, including 32 subjects with echocardiographic LVH. The sensitivity of single traditional ECG-LVH criteria in detecting echocardiographic LVH was 9–34% and their respective specificity averaged 78–100%. The ability to predict echocardiographic LVH was higher for S-waves than R-waves (mean area under the receiver operating curve (AUC): 0.62–0.70 vs. 0.58–0.65). Among combinations of R- and S-waves, the discriminating ability was highest for the Cornell voltage (AUC: 0.71) compared to the Sokolow–Lyon, Romhilt and Gubner–Ungerleider voltage (AUC: 0.62–0.68). By multiple regression, peak aortic pressure gradient was positively related to the Sokolow–Lyon (β = 1.7 ± 0.5, p = 0.002) and Romhilt voltage (β = 1.3 ± 0.5, p = 0.01), but not Cornell (0.5 ± 0.3, p = 0.2) or Gubner-Ungerleider voltage (β = 0.0 ± 0.5, p > 0.9), regardless of LV mass index. In conclusion, echocardiographic LVH and stenosis severity appear to have distinct associations with traditional ECG-LVH criteria in AS. A moderate diagnostic superiority of the Cornell voltage criterion with regard to anatomic LVH might result from its unique ability to include depolarization vectors in both the frontal and horizontal plane with consequent lesser sensitivity to the confounding effect of obesity.

scholarly journals Features of arterial hypertension patients with discrepancies in vectorcardiographic and echocardiographic conclusions about the presence of left ventricular hypertrophy [Original Article]

2019 ◽  
Vol 16 (3) ◽  
pp. 13-18
Author(s):  
Elena V Blinova ◽  
Tamara A Sakhnova ◽  
Olga Ya Chaykovskaya ◽  
Marina A Saidova ◽  
Galina V Ryabykina
Keyword(s):  
Blood Pressure ◽  
Left Ventricular Hypertrophy ◽  
Arterial Hypertension ◽  
Systolic Blood Pressure ◽  
Diastolic Dysfunction ◽  
Ventricular Hypertrophy ◽  
False Negative ◽  
Left Ventricular ◽  
True Negative ◽  
Cornell Product

Aim. To determine the features of patients with arterial hypertension (AH) with a discrepancy of electrocardiographic, including vectorcardiographic (VCG) and echocardiographic conclusions about the presence of left ventricular hypertrophy (LVH). Materials and methods. 140 patients with AH were examined (mean age 59.8±12.0 years, 33.6% of men). The Sokolov- Lyon criterion, the Cornell product, the sum of the amplitudes of the R wave in lead X and the S wave in lead Z of the synthesized vectorcardiogram (RX+SZ) and the amplitude of the maximal QRS vector (MQRS) were analyzed. Left ventriclular myocardial mass (LVMM) was calculated using the ASE formula, LVMM/height2.7 more than 44 g/m2.7 in women and more than 48 g/m2.7 in men was considered a criterion for LVH.Results. In patients with AH, pathological RX+SZ and MQRS values were significantly more frequent compared with the Sokolov-Lyon criterion and the Cornell product. Pathological values of RX+SZ and MQRS were met both in patients with an increased and with a normal indexed LVMM. Patients with "true-positive" VCG findings compared with "false-negative" had significantly larger values of the relative wall thickness, LVMM and indexed LVMM. Patients with “false positive” VCG findings compared with “true-negative” were more likely to have left ventricular diastolic dysfunction (90% and 68%, respectively). Patients with the presence of VCG criteria for LVH, both with normal and with an increased indexed LVMM, were characterized by higher values of systolic blood pressure and higher values of the QRS duration. Conclusion. In patients with arterial hypertension, pathological values of vectorcardiographic indices were significantly more frequent compared with the Sokolov-Lyon criterion and the Cornell product. VCG indices allowed to separate groups of patients with the presence and absence of diastolic dysfunction of the left ventricle, as well as groups of patients with normal and elevated values of systolic blood pressure.

Abstract TP200: African American Young Adults with Ischemic Stroke Have High Rates of Left Ventricular Hypertrophy

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Yan Hou ◽  
Elizabeth Aradine ◽  
Kathleen Ryan ◽  
Prachi Mehndiratta ◽  
Seemant Chaturvedi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
White Women ◽  
Statistical Significance ◽  
Young Patients ◽  
White Men ◽  
Left Ventricular ◽  
Stroke Patients ◽  
History Of

Introduction: It is well known that African Americans (Afr-Am) have a higher prevalence of hypertension (HTN) compared to Whites. Few studies have compared Afr-Am and Whites for the prevalence of left ventricular hypertrophy (LVH; a marker of long-standing hypertension) in young ischemic stroke patients with and without a history of hypertension to assess hypertension severity and undiagnosed longstanding hypertension. We hypothesized that the prevalence of LVH by echocardiography would be higher in Afr-Am than in their White counterparts. Methods: We identified 1033 patients from a population-based case control study of young patients with first-time ischemic stroke (age 18 to 49 years old, enrolled from 1992-2006) from the Baltimore-Washington area. Patients (n=191, 16%) without an echocardiogram were excluded yielding an analysis sample of 842. Prevalence of LVH by echocardiography (Echo-LVH) were determined in those with and without a history of HTN, stratified by sex and race. Age-adjusted odds ratios and 95% confidence intervals comparing Afr-Am and Whites for the prevalence of Echo-LVH were calculated by logistic regression. Results: Of the 842 young stroke patients included in this study, the median age was 43.0, 55.2% were men, and 48.7 % were Afr-Am. Echo-LVH was common in young patients with ischemic stroke, even patients without a prior history of hypertension. Afr-Am women, both with and without a history of HTN, had higher age-adjusted prevalence of LVH than White women. Afr-Am men with no history of HTN had higher age-adjusted prevalence of Echo-LVH than White men. Afr-Am men with history of HTN had the highest prevalence of LVH, but the age-adjusted comparison with White men with HTN did not achieve statistical significance. Conclusions: The evidence suggests that Afr-Am have greater end organ damage from HTN, even among those who do not have an established diagnosis of HTN. These findings emphasize the need for earlier screening and treatment of HTN in young Afr-Am adults.

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