Accuracy of echocardiography versus electrocardiography in detecting left ventricular hypertrophy: Comparison with postmortem mass measurements

Woythaler, Julius; Singer, S.; Kwan, Oi Ling; Meltzer, Richard S.; Reubner, Boris; Bommer, William J.; DeMaria, Anthony N.

doi:10.1016/s0735-1097(83)80167-3

Cited by 208 publications

(61 citation statements)

References 18 publications

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“…However, it is well known that the sensitivity of ECG to detect LVH is low, independently of the definition of LVH. 4 Echocardiography is more sensitive than ECG in diagnosing LVH and predicting CV risk, and may help in the more precise stratification of overall risk and in the determination of therapy. 5,6 Nevertheless, the routine execution of echocardiographic examination in hypertensive patients, although useful on various grounds, may lead to some difficulties.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and predictors of left ventricular hypertrophy in patients with hypertension and normal electrocardiogram

Nardi

Palermo

Mulè

et al. 2012

Eur J Prev Cardiolog

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Background: Electrocardiography (ECG) has low sensitivity for detecting left ventricular hypertrophy (LVH), while echocardiography cannot be routinely performed. Design/methods: In this study we evaluate the prevalence of LVH and diastolic dysfunction in hypertensive patients with normal ECG. We excluded patients with cardiovascular (CV) diseases, diabetes, chronic kidney disease, or presenting ECG-LVH or other ECG anomalies. The enrolled 440 hypertensive patients underwent echocardiographic examination (Acuson Sequoia 512); LV mass was indexed by body surface area (LVMI) and LVH was defined as LVMI >125 g/m 2 in men and >110 g/m 2 in women. Diastolic function was evaluated by mitral inflow and tissue Doppler imaging (TDI). Results: The prevalence of LVH was 8.18% (95% confidence interval [CI] 5.97-11.1%). Multiple regression analysis showed that the only variable independently associated with LVH was duration of hypertension (p < 0.001). The receiver operating characteristic (ROC) curve showed that duration of hypertension was a powerful predictor of LVH, with an area under the curve (AUC) of 0.878 and p < 0.0001. Further, in patients with LVH the mean difference of LVMI from the cut-off value for LVH was 12.3 AE 9.19 g/m 2 . Diastolic dysfunction, defined as early diastolic myocardial velocity (Em) <0.08 m/s, was detected only in 3.2% of patients. Conclusions: The prevalence of LVH among hypertensive patients with normal ECG, free of diabetes and of CV diseases is low; moreover, patients with echocardiographic LVH presented LVMI values that identified mild LVH. Few cases of impaired diastolic function were registered. We suggest that in hypertensive patients with such characteristics the echocardiographic examination should be reserved to those who present with higher duration of hypertension.

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Section: Introductionmentioning

confidence: 99%

Prevalence and predictors of left ventricular hypertrophy in patients with hypertension and normal electrocardiogram

Nardi

Palermo

Mulè

et al. 2012

Eur J Prev Cardiolog

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“…Calculations of left ventricular mass with M-mode echocardiography was early established as a valid non-invasive measure of hypertrophy verified by autopsy [5,6] . Despite the development of new diagnostic methods, M-mode echocardiography is still the method of choice in epidemiological surveys [7] .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of left ventricular hypertrophy in a general population; The Tromsø Study

Schirmer

Lunde²,

Rasmussen³

1999

European Heart Journal

104

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Aims Left ventricular hypertrophy has been shown to be an independent predictor of cardiovascular morbidity. Acknowledging the skewed distribution of left ventricular mass, we wanted to develop criteria for left ventricular hypertrophy based on percentiles of left ventricular mass, and observe the effect on estimates of left ventricular hypertrophy prevalences in different subgroups and on the relationship to cardiovascular risk factors in a general population. Methods and ResultsIn a population-based sample of 3287 subjects aged 25-85 years, left ventricular mass was estimated using M-mode echocardiography. A 'healthy' subgroup was used as a reference sample to define sexspecific left ventricular hypertrophy criteria. Sex-specific 97·5 percentiles for left ventricular mass by height, based on the reference sample, were 145·5 and 125·4 g . m 1 , for men and women, respectively. The prevalences of left ventricular hypertrophy in the total population were 14·9% for men and 9·1% for women. The main independent predictors of left ventricular hypertrophy were male gender, body mass index, systolic blood pressure, valvular heart disease, cardiovascular disease and antihypertensive medication. Body mass index and systolic blood pressure had a strong synergistic association with left ventricular hypertrophy in men, but not in women. ConclusionAn alternative framework for defining left ventricular hypertrophy is provided. Body mass index is the culprit factor for risk of left ventricular hypertrophy. Our study indicates that weight reduction is a relevant measure for treatment and possibly prevention of left ventricular hypertrophy in a substantial part of the general population. (Eur Heart J 1999; 20: 429-438)

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“…badanie echokardiograficzne uznawane jest obecnie jako referencyjnie w diagnostyce LVH, a wyliczona na jego podstawie wartość masy lewej komory koreluje liniowo z ryzykiem zgonu chorego [11,12]. okazuje się jednak, że u chorych z rozpoznanym nadciśnieniem tętniczym spełnienie elektrokardiograficznych wskaźników przerostu lewej komory daje ważne, komplementarne i niezależne informacje na temat ryzyka zgonu z przyczyn ogólnych i sercowo-naczyniowych, a kwalifikację do badania echokardiograficznego zaleca się dokonywać na podstawie danych klinicznych chorego i zmian obserwowanych w zapisie ekg [13][14][15][16].…”

Section: Wnioskiunclassified

Sensitivity and specificity of ECG-LVH indexes in the group of patients above 60 years old with arterial hypertension

Młynarczyk¹,

Gać²,

Mazur³

et al. 2016

fmpcr

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1 Studenckie koło naukowe Profilaktyki chorób Sercowo-naczyniowych uniwersytetu Medycznego we wrocławiu 2 klinika chorób wewnętrznych, zawodowych i nadciśnienia tętniczego uniwersytetu Medycznego we wrocławiu 3 zakład elektrokardiologii i Prewencji chorób Sercowo-naczyniowych uniwersytetu Medycznego we wrocławiu A -przygotowanie projektu badania, B -zbieranie danych, C -analiza statystyczna, D -interpretacja danych, E -przygotowanie maszynopisu, F -opracowanie piśmiennictwa, G -pozyskanie funduszy Wstęp. elektrokardiogram stanowi przydatne badanie wykorzystywane w diagnostyce powikłań narządowych nadciśnienia tętniczego. Cel pracy. ocena wiarygodności diagnostycznej elektrokardiograficznych wskaźników przerostu lewej komory serca (LVH) u osób chorujących na pierwotne nadciśnienie tętnicze powyżej 60. r.ż. w odniesieniu do badania echokardiograficznego. Materiał i metody. badaniem objęto dwie grupy chorych: powyżej 60. r.ż. (n = 22) i poniżej 60. r.ż. (n = 19). celem oceny wskaź-ników LVH u wszystkich chorych wykonano 12-odprowadzeniowy zapis ekg oraz przezklatkowe badanie echokardiograficzne. Wyniki. odsetek pacjentów spełniających przynajmniej jedno kryterium elektrokardiograficzne LVH był zbliżony w obu badanych grupach chorych (36,4% w grupie powyżej 60. r.ż. vs. 36,8% w grupie poniżej 60. r.ż.), mimo że częstość występo-wania LVH w badaniu echokardiograficznym była większa w grupie chorych powyżej 60. r.ż. (72% vs. 31,2%). w grupie chorych powyżej 60. r.ż. czułość i swoistość wskaźników elektrokardiograficznych wyniosła odpowiednio -31,3 i 50%, podczas gdy w grupie chorych poniżej 60. r.ż. -66,6 i 76,9%. wartość predykcyjna dodatnia wskaźników elektrokardiograficznych LVH była wyższa w grupie chorych powyżej 60. r.ż. (0,625 vs. 0,571). natomiast wartość predykcyjna ujemna w tej grupie była niższa w porównaniu do grupy chorych poniżej 60. r.ż. (0,214 vs. 0,833). Wnioski. w porównaniu do chorych przed 60. r.ż., w grupie chorych powyżej 60. r.ż. 12-odprowadzeniowy zapis ekg charakteryzuje się niższą czułością i swoistością oceny LVH. w tej grupie chorych wskaźniki elektrokardiograficzne wydają się być bardziej przydatne przy potwierdzeniu choroby, podczas gdy w grupie pacjentów poniżej 60. r.ż. -przy wykluczeniu choroby. Słowa kluczowe: nadciśnienie tętnicze, przerost mięśnia sercowego, ekg, geriatria.Background. a standard electrocardiograph (ecg) is considered to be a useful examination to diagnose chronic organ complications of arterial hypertension. Objectives. the aim of this study was the diagnostics reliability assessment of ecg-LVH indexes that were met in the group of patients with arterial hypertension over 60 years of age in relation to echocardiography. Material and methods. two groups of hypertensive subjects: aged above 60 years old (n = 22) and under 60 years old (n = 19) underwent a 12-lead ecg examination and conventional echocardiography. Results. the number of patients, who met at least one electrocardiographic LVH criterion, was similar in both groups (36.4% of patients above 60% vs. 36.8% i...

show abstract

Accuracy of echocardiography versus electrocardiography in detecting left ventricular hypertrophy: Comparison with postmortem mass measurements

Cited by 208 publications

References 18 publications

Prevalence and predictors of left ventricular hypertrophy in patients with hypertension and normal electrocardiogram

Prevalence and predictors of left ventricular hypertrophy in patients with hypertension and normal electrocardiogram

Prevalence of left ventricular hypertrophy in a general population; The Tromsø Study

Sensitivity and specificity of ECG-LVH indexes in the group of patients above 60 years old with arterial hypertension

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