A point-score system for the ECG diagnosis of left ventricular hypertrophy

Romhilt, Donald W.; Estes, E. Harvey

doi:10.1016/0002-8703(68)90035-5

Cited by 795 publications

(286 citation statements)

References 7 publications

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“…HRA has been found in varying incidence in association with the postpericardiotomy syndrome, the postmyocardial infarction syndrome, after blunt or penetrating chest trauma, in rheumatic fever, recurrent idiopathic pericarditis, cardiomyopathies, and various other disease states, in addition to cardiac graft rejection.5'-`The presence and role of HRA in these various cardiac disease states have also been the subject of extensive reviews.10, 11 HRA has been best described in the postpericardiotomy syndrome, and has been shown to be nonspecies specific and partially organ-specific.8 9 Absorption studies have shown that HRA binds to heterologous as well as autologous heart tissue, to skeletal muscle as well as to cardiac muscle, and, to a lesser degree, to smooth muscle. Absorption with muscle but not with other organs neutralized serum containing HRA.…”

Section: Discussionmentioning

confidence: 99%

Exercise-induced ST elevation in patients without myocardial infarction.

Longhurst¹,

Kraus²

1979

Circulation

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SUMMARY A review of 6040 consecutive exercise tests yielded 106 patients without previous myocardial infarction (MI) who had exercise-induced ST elevation (. 0.5 mm in a 15-lead ECG system). In 46, ST elevation was correlated with left ventriculography and coronary angiography. Coronary artery disease (CAD) (> 70% narrowing) was detected in 40 of 46 patients: 12 patients had one-vessel disease, 13 had two-vessel disease, and 15 had three-vessel disease. Resting ventriculograms were normal in 36 of 40 patients. Of 21 patients with anterior (V,-V3) ST glutamic oxaloacetic transaminase). All patients who did not fulfill the above criteria (i.e., those in whom an infarction was uncertain) were rejected from the study; patients who either fulfilled or had none of these criteria were included in the study.Of the 6040 patients tested, 399 (6.6%) had exerciseinduced ST elevation and a myocardial infarction. The majority (95%) of the 399 patients had ST elevation over the area of infarction. One hundred six patients (1.7% of the total population) developed ST elevation and had no evidence of a myocardial infarction, LVH or bundle branch block and were not taking digitalis. Forty-six patients in this latter group had undergone diagnostic cardiac catheterization. Another 21 patients with LVH and 12 patients taking digitalis also had exercise-related ST elevation. Six patients with LVH, one of whom was also taking digitalis, were catheterized. The stress tests were carried out according to either the multistaged Bruce or Balke protocols.'2 13 Each patient's blood pressure was monitored by indirect sphygmomanometry. Also, all patients were questioned during and after the exercise test about the development of symptoms. Angina pectoris was recorded if a patient developed exertional or postexer-

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Section: Discussionmentioning

confidence: 99%

Exercise-induced ST elevation in patients without myocardial infarction.

Longhurst¹,

Kraus²

1979

Circulation

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“…2,3 The sensitivity of the ECG is also dependant on the population in which it is applied. Although the sensitivity of several ECG criteria for LVH may be acceptable, albeit low (from 58% for the Romhilt-Estes score 4 to 41% for the Cornell voltage 5 ), among patients with disparate cardiac conditions, the sensitivity of the ECG consistently decreases in the general population. For example, the sensitivity of the Cornell voltage criterion was only 10% in men and 22% in women in the Framingham Heart Study 2 and only 12% in men and 19% in women in the Progetto Ipertensione Umbria Monitoraggio Ambulatoriale (PIUMA) study.…”

Section: How Good Is the Ecg In Detecting True Anatomic Lvh?mentioning

confidence: 99%

The prognostic value of the ECG in hypertension: where are we now?

Ang

Lang

2008

J Hum Hypertens

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In hypertension, the presence of left ventricular hypertrophy (LVH) is associated with increased risk of both cardiovascular morbidity and mortality. To date, the electrocardiogram (ECG) remains the cornerstone of LVH diagnosis in clinical practice because it is universally available, technically easy to perform and highly specific. In the most recent European Society of Hypertension/European Society of Cardiology guidelines for the treatment of arterial hypertension, the Sokolow-Lyon voltage criterion was recommended as part of all routine assessment of subjects with hypertension. However, the use of the ECG in the diagnosis of LVH is somewhat limited by its poor sensitivity. In this review article, we discuss the individual strength and weaknesses of the commonly used ECG criteria in diagnosing LVH. In addition, we present the latest data on the prognostic significance of ECG LVH and the survival differences conferred in different genders. In view of the recent Losartan Intervention for Endpoint Reduction in Hypertension trial, the prognostic benefit of LVH regression will also be addressed. Finally, with the wider availability of echocardiography, the role of combining both modalities to improve risk stratification in hypertension is reviewed.

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“…Standardized computerized ECG criteria as described by the GE 12-lead electrographic analysis program were used for the diagnosis of Q-waves, ST changes, and bundle branch blocks. From these measurements, the Romhilt-Estes criteria for left ventricular hypertrophy (LVH), 12 QRST spatial angles, 13 Cardiac Infarction Injury Scores (CIIS) 14 and Selvester 15 scores were calculated.…”

Section: Ecg Analysismentioning

confidence: 99%

Prognostic value of the computerized ECG in Hispanics

Pérez¹,

Yaw²,

Myers³

et al. 2007

Clinical Cardiology

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SummaryBackground: The prevalence and prognostic values of electrocardiogram (ECG) abnormalities in Hispanics have not been compared to other ethnicities in a large population. Despite a worse cardiovascular risk profile, the prevalence of cardiovascular disease is lower in Hispanics compared to non-Hispanics.Hypothesis: We hypothesized that ECG abnormalities were less common in Hispanics and were not as strongly associated with cardiovascular mortality.Methods: 45,563 ECGs ordered for usual clinical indications in a Veteran's hospital were available for analysis. 1,392 patients who died within one week of the ECG were excluded. Demographic characteristics were recorded and the population was followed for an average of 7.5 years using the California Death Index. The presence of baseline ECG characteristics were recorded and analyzed using the GE/Marquette computerized ECG system. Age, sex and heart rate adjusted Cox hazard ratio analyses were performed.Results: Being Hispanic was associated with lower cardiovascular death, with a hazard ratio (HR) of 0.76

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A point-score system for the ECG diagnosis of left ventricular hypertrophy

Cited by 795 publications

References 7 publications

Exercise-induced ST elevation in patients without myocardial infarction.

Exercise-induced ST elevation in patients without myocardial infarction.

The prognostic value of the ECG in hypertension: where are we now?

Prognostic value of the computerized ECG in Hispanics

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