Electrocardiography for diagnosis of left ventricular hypertrophy in hypertensive patients with atrial fibrillation

Angeli, Fabio; Verdecchia, Paolo; Cavallini, Claudio; Aita, Adolfo; Turturiello, Dario; Trapasso, Monica; Fano, Michelantonio De; Reboldi, Gianpaolo

doi:10.1016/j.ijchy.2019.100004

Cited by 5 publications

(5 citation statements)

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“…Nonetheless, the relationships between these two disorders and how they simultaneously act in increasing the risk of vascular events are not completely understood. Taking advantage of the unique features of Umbria-AF registry [11], we tried to elucidate in a large cohort of AF patients the potential mechanisms explaining the increased vascular risk related to COPD. Results of our cross-sectional analysis highlighted the notion that AF patients with COPD have a higher risk of cardio- and cerebro-vascular complications than AF patients without this lung disease.…”

Section: Discussionmentioning

confidence: 99%

“…Details of this Registry have been reported elsewhere [11]. Enrollment is being performed in 22 Hospitals or out-patient facilities in the setting of the Italian Health System, beginning in January 2013.…”

Section: Methodsmentioning

confidence: 99%

“…For enrollment, patients must be affected by AF at entry into the Registry or, in case of paroxysmal or persistent AF currently in sinus rhythm, by evidence of AF within one year before entry (standard ECG, ECG-Holter monitoring, or pacemaker diagnostics are also accepted for diagnosis of AF) [11].…”

Section: Methodsmentioning

confidence: 99%

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Detrimental Impact of Chronic Obstructive Pulmonary Disease in Atrial Fibrillation: New Insights from Umbria Atrial Fibrillation Registry

et al. 2019

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Background and objectives: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Among extra-pulmonary manifestations of COPD, atrial fibrillation (AF) is commonly observed in clinical practice. The coexistence of COPD and AF significantly affects the risk of cardiovascular morbidity and mortality. Nonetheless, the mechanisms explaining the increased risk of vascular events and death associated to the presence of COPD in AF are complex and not completely understood. We analyzed data from an Italian network database to identify markers and mediators of increased vascular risk among subjects with AF and COPD. Materials and Methods: Cross-sectional analysis of the Umbria Atrial Fibrillation (Umbria-FA) Registry, a multicenter, observational, prospective on-going registry of patients with non-valvular AF. Of the 2205 patients actually recruited, 2159 had complete clinical data and were included in the analysis. Results: the proportion of patients with COPD was 15.6%. COPD patients had a larger proportion of permanent AF when compared to the control group (49.1% vs. 34.6%, p < 0.0001) and were more likely to be obese and current smokers. Other cardiovascular risk factors including chronic kidney disease (CKD), peripheral artery disease and subclinical atherosclerosis were more prevalent in COPD patients (all p < 0.0001). COPD was also significantly associated with higher prevalence of previous vascular events and a history of anemia (all p < 0.0001). The thromboembolic and bleeding risk, as reflected by the CHA2DS2VASc and HAS-BLED scores, were higher in patients with COPD. Patients with COPD were also more likely to have left ventricular (LV) hypertrophy at standard ECG than individuals forming the cohort without COPD (p = 0.018). Conclusions: AF patients with COPD have a higher risk of vascular complications than AF patients without this lung disease. Our analysis identified markers and mediators of increased risk that can be easily measured in clinical practice, including LV hypertrophy, CKD, anemia, and atherosclerosis of large arteries.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Detrimental Impact of Chronic Obstructive Pulmonary Disease in Atrial Fibrillation: New Insights from Umbria Atrial Fibrillation Registry

et al. 2019

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“…The incidence of left ventricular hypertrophy may vary and mostly depends on diagnostic method. The standard ECG is reliable for diagnosing LV hypertrophy, regardless of the presence of atrial fibrillation or sinus rhythm at the time of ECG recording 14 . The newly proposed ECG criteria (Peguero) are calculated by adding the amplitude of the deepest S wave of D lead in any single lead to the S‐wave amplitude of lead V 4 .…”

Section: Discussionmentioning

confidence: 99%

Electrocardiographic criteria which have the best prognostic significance in hypertensive patients with echocardiographic hypertrophy of left ventricle: 15‐year prospective study

Djordjević

Tasić

Kostić³

et al. 2020

Clinical Cardiology

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Background Electrocardiography is the first‐choice technique for detecting left ventricular hypertrophy in patients with arterial hypertension. It is necessary to know the probable outcome for every patient during the treatment, with the aim of improving cardiovascular event prevention. Hypothesis Certain electrocardiographic criteria for left ventricular hypertrophy may predict outcomes of patients with left ventricular hypertrophy during a 15‐year follow‐up. Methods Fifteen‐year prospective study of 83 consecutive patients (53 male and 30 female; mean age 55.3 ± 8.1) with echocardiographic left ventricular hypertrophy (left ventricular mass index 170.3 ± 31.6 g/m2). Electrocardiographic left ventricular hypertrophy was determined by means of Gubner‐Ungerleider voltage, Lewis voltage, voltage of R wave in aVL lead, Lyon‐Sokolow voltage, Cornell voltage and Cornell product, voltage RV6 and RV5 ratio, Romhilt‐Estes score, Framingham criterion and Perugia criterion. Results One or more composite events were registered in 32 (38.5%) patients during 15‐year follow‐up. Positive Lyon‐Sokolow score (17.6% vs. 47.3%; P < 0.05), Lewis voltage (9.8% vs. 21.9%; P < 0.05), Cornell voltage (15.7% vs. 37.5%; P < 0.05), and Cornell product (9.8% vs. 34.4%; P < 0.01) were more frequent in a group of patients with composite events. Odd ratio for Cornell product was 4.819 (95% CI 1.486‐15.627). Conclusion Patients with echocardiographic left ventricular hypertrophy who had positive Lewis voltage, Lyon‐Sokolow voltage, Cornell voltage, and Cornell product showed worse 15‐year outcome. The strongest predictor of cardiovascular events was positive result of Cornell product.

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“…The work [14] suggested adjustment in Sokolow-Lyon voltage that is a 4 mm reduction in the case of the overweight patient and an 8 mm reduction in ECG voltage for a patient with obesity to improve sensitivity without affecting the high value of specificity. On the other hand, ECG is a reliable tool for diagnosis of LVH in the hypertensive patient of sinus rhythm or atrial fibrillation [18] and to overcome the problem of high specificity. The authors of [16] proposed an ECG criteria for LVH with low sensitivity using data mining.…”

Section: Related Workmentioning

confidence: 99%

Predicting the presence of Left Ventricular Hypertrophy using Este’s Criteria with Support Vector Machine

Sinha

Joshi

2022

Preprint

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Left ventricular hypertrophy (LVH) is the heart condition where the walls of the left ventricle would be thicker than the normal condition. That obstructs the electrical activity of the heart and hence significantly decreases the pumping efficiency. LVH develops as the response to pressure overload that might arise from high blood pressure, stenosis etc. This condition of the heart can be reversed if diagnosed and treated in time. Its symptoms like short breathing, fatigue, palpitation of the heart, dizziness, chest pain after exercise are often misinterpreted or masked by the process of homeostasis, and it develops silently over the years. The prediction of presence of LVH using effective machine learning model would be helpful to have early diagnosis of the disease. This paper focuses on the prediction of Left Ventricular Hypertrophy (LVH) using the SVM machine learning model with the help of an electrocardiogram (ECG). The proposed methodology could be integrated with the IoT framework for smart healthcare solutions. Data is taken from the UCI machine learning repository i.e Cleveland, Hungary, Switzerland, and the VA Long Beach database consisting of 920 subjects. Data is split into 8:2 for training and testing purposes. Python 3.0 is used to analyze the data and the classification is verified by the 10-fold cross-validation technique. In this study, normal subjects and subjects with a high probability of LVH are classified successfully with greater ROC-AUC value than 0.5 which shows the unbiased classification. The results show that the proposed model with enhanced accuracy of 81+% and high specificity of 92.36% stands promising for futuristic smart healthcare applications.

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Electrocardiography for diagnosis of left ventricular hypertrophy in hypertensive patients with atrial fibrillation

Cited by 5 publications

References 30 publications

Detrimental Impact of Chronic Obstructive Pulmonary Disease in Atrial Fibrillation: New Insights from Umbria Atrial Fibrillation Registry

Detrimental Impact of Chronic Obstructive Pulmonary Disease in Atrial Fibrillation: New Insights from Umbria Atrial Fibrillation Registry

Electrocardiographic criteria which have the best prognostic significance in hypertensive patients with echocardiographic hypertrophy of left ventricle: 15‐year prospective study

Predicting the presence of Left Ventricular Hypertrophy using Este’s Criteria with Support Vector Machine

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