Evaluation of electrocardiographic criteria for left ventricular hypertrophy based on anatomical comparison

Kimura, M; Matsushita, Satoru; Nakahara, Ken-ichi; Miyakawa, Akihiko; Kuramoto, Kizuku

doi:10.1016/s0022-0736(87)80088-2

Cited by 9 publications

(2 citation statements)

References 17 publications

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“…Some studies have found the QRS voltage to be significantly increased [17][18][19] , others have found a nonsignificant trend of increase in QRS amplitude 20 , whereas some others have found the amplitude to be decreased in SHR compared with that in normotensive rats [21][22][23] . The high number of so-called false negative ECG results and low sensitivity of ECG voltage criteria in clinical diagnostics is also well documented [24][25][26][27] .…”

Section: Discussionmentioning

confidence: 90%

QRS Voltage-Duration Product in the Identification of Left Ventricular Hypertrophy in Spontaneously Hypertensive Rats

Bachárová

Kyselovič²,

Klimas³

2002

Arq. Bras. Cardiol.

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Section: Discussionmentioning

confidence: 90%

QRS Voltage-Duration Product in the Identification of Left Ventricular Hypertrophy in Spontaneously Hypertensive Rats

Bachárová

Kyselovič²,

Klimas³

2002

Arq. Bras. Cardiol.

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“…Of particular relevance here is the high proportion of false-negatives, resulting in a low sensitivity of voltage criteria in LVH detection 25 . Reported sensitivities are mostly below 50%, ranging to 20%, or even lower [26][27][28] . It means, on the other hand, that the percentage of false-negative results is over 50%, up to 80% and even more.…”

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confidence: 99%

Evidence-based medicine. A lesson for electrocardiography?

Bachárová¹

2003

Arq. Bras. Cardiol.

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Updateplaced by new imaging methods in many applications. And in some applications, ECG is even considered obsolete, eg, in the diagnostics of left ventricular hypertrophy (LVH).The rational way to increase the interest of cardiologists, to attract young scientists, and to increase the value of ECG, is to analyze and consequently to reduce its limitations. This means, first, to reevaluate the "old truths" and "myths," second, to focus attention on the unique information provided by electrocardiography, and third, to recognize the added value of ECG in the context of other diagnostic methods, such as echocardiography, scintigraphy, NMR, and many others. I do not consider the frequently presented statement that ECG is easily available and inexpensive to be a sound argument.The need to constantly reevaluate accumulated knowledge and evidence is not limited to electrocardiography. It is a necessity for most fields of medical and professional practice. In the last 2 decades, this need has been formulated as evidence-based medicine (EBM) demanding the critical appraisal of evidence. Sackett et al 2 defined evidencebased medicine as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of EBM means integrating individual clinical expertise with the best available external clinical evidence from systematic research. The evidence-based approach includes 4 stages: the formulation of answerable questions; the search for the best evidence; critical appraisal of the evidence; the decision to apply the conclusions to patients' health care.EBM provides general principles and a standardized way to reevaluate knowledge. The aim of this article is to apply the principles of evidence-based medicine to electrocardiography and to begin discussions about evidencebased electrocardiography. An evidence-based medicine approach is applied to the ECG diagnostics of left ventricular hypertrophy based on voltage criteria not currently considered a "hot topic" and one in which a decline in interest is evident. We will assess whether an EBM approach is helpful in our efforts to reevaluate the "old truths," to define the unique information provided by electrocardiography and Electrocardiography is an old diagnostic method, introduced at the end of the 19th century. Now, at the beginning of the 21st century, one of the main concerns of electrocardiologists is a decreased interest in electrocardiography in general, particularly among young scientists 1 . Naturally, electrocardiography has strengths and weaknesses related to its age. On the one hand, it is a wellestablished, accepted, and respected clinical and experimental method, based on a substantial body of knowledge and experience, accumulated during the century of its existence. On the other hand, limitations also exist related to this age: fixed out-of-date ideas and beliefs, modifications caused by rewriting and recitations, and a gap between fixed ideas about ECG and up-to-date nonelectrocardiologi...

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The heart in polymyositis: A prospective evaluation of 26 patients

Taylor

Wortham

Burge

et al. 1993

Clinical Cardiology

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Summary:Although cardiac abnormalities have been repoded in patients with idiopathic polymyositis-dermatomyositis (PM), the nature and extent of these abnormalities have varied. The purpose of this study was to determine the prevalence and to obtain a better description of the spectrum of cardiac abnormalities in a cohort of patients with PM by use of a thorough noninvasive cardiac evaluation. Accordingly, we studied 26 patients with a history of PM and clinically inactive myositis (22 polymyositis, 4 dermatomyositis) between June 1984 and June 1991. Examination included history, physical examination, 12-lead elecmardiography, 24-h ambulatory electrocardiographic monitoring, chest radiography, transthoracic echocadbgraphy, and radionuclide ventridography. Ofthe patients studied, 77% were taking corticostemid medications at a mean dose of 39 f 27 mg at the time of their evaluation. All 26 patients were identified as having two or more cardiac abnormalities. Cardiac symptoms and signs were common (62 and 81%, respectively), but were generally nonspecific. Electmcardiographic findings were most common (in 85% of cases), followed by findings on ambulatory monitoring (77%), echocardiography (42%), and radionuclide ventriculography (15%). The prevalence of m i d valve prolapse (8%) and hyperkinetic left ventricular contraction (1 2%) was significantly lower than previ-

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Evaluation of electrocardiographic criteria for left ventricular hypertrophy based on anatomical comparison

Cited by 9 publications

References 17 publications

QRS Voltage-Duration Product in the Identification of Left Ventricular Hypertrophy in Spontaneously Hypertensive Rats

QRS Voltage-Duration Product in the Identification of Left Ventricular Hypertrophy in Spontaneously Hypertensive Rats

Evidence-based medicine. A lesson for electrocardiography?

The heart in polymyositis: A prospective evaluation of 26 patients

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