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ECG is an inefficient screening-tool for left ventricular hypertrophy in normotensive African children population
BACKGROUND: Left ventricular hypertrophy (LVH) is a marker of pediatric hypertension and predicts development of cardiovascular events. Electrocardiography (ECG) screening is used in pediatrics to detect LVH thanks to major accessibility, reproducibility and easy to use compared to transthoracic ech...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
PeerJ Inc.
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5018662/ https://www.ncbi.nlm.nih.gov/pubmed/27651998 http://dx.doi.org/10.7717/peerj.2439 |
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author | Di Gioia, Giuseppe Creta, Antonio Campanale, Cosimo Marco Fittipaldi, Mario Giorgino, Riccardo Quintarelli, Fabio Satriano, Umberto Cruciani, Alessandro Antinolfi, Vincenzo Di Berardino, Stefano Costanzo, Davide Bettini, Ranieri Mangiameli, Giuseppe Caricato, Marco Mottini, Giovanni |
author_facet | Di Gioia, Giuseppe Creta, Antonio Campanale, Cosimo Marco Fittipaldi, Mario Giorgino, Riccardo Quintarelli, Fabio Satriano, Umberto Cruciani, Alessandro Antinolfi, Vincenzo Di Berardino, Stefano Costanzo, Davide Bettini, Ranieri Mangiameli, Giuseppe Caricato, Marco Mottini, Giovanni |
author_sort | Di Gioia, Giuseppe |
collection | PubMed |
description | BACKGROUND: Left ventricular hypertrophy (LVH) is a marker of pediatric hypertension and predicts development of cardiovascular events. Electrocardiography (ECG) screening is used in pediatrics to detect LVH thanks to major accessibility, reproducibility and easy to use compared to transthoracic echocardiography (TTE), that remains the standard technique. Several diseases were previously investigated, but no data exists regarding our study population. The aim of our study was to evaluate the relationship between electrocardiographic and echocardiographic criteria of LVH in normotensive African children. METHODS: We studied 313 children (mean age 7,8 ± 3 yo), in north-Madagascar. They underwent ECG and TTE. Sokolow-Lyon index was calculated to identify ECG-LVH (>35 mm). Left ventricle mass (LVM) with TTE was calculated and indexed by height(2.7) (LVMI(2.7)) and weight (LVMI(w)). We report the prevalence of TTE-LVH using three methods: (1) calculating percentiles age- and sex- specific with values >95th percentile identifying LVH; (2) LVMI(2.7) >51 g/m(2.7); (3) LVMI(w) >3.4 g/weight. RESULTS: 40 (13%) children showed LVMI values >95th percentile, 24 children (8%) an LVMI(2.7) >51 g/m(2.7) while 19 children (6%) an LVMI(w) >3.4 g/kg. LVH-ECG by Sokolow-Lyon index was present in five, three and three children respectively, with poor values of sensitivity (ranging from 13 to 16%), positive predictive value (from 11 to 18%) and high values of specificity (up to 92%). The effects of anthropometrics parameters on Sokolow-Lyon were analyzed and showed poor correlation. CONCLUSION: ECG is a poor screening test for detecting LVH in children. In clinical practice, TTE remains the only tool to be used to exclude LVH. |
format | Online Article Text |
id | pubmed-5018662 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | PeerJ Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-50186622016-09-20 ECG is an inefficient screening-tool for left ventricular hypertrophy in normotensive African children population Di Gioia, Giuseppe Creta, Antonio Campanale, Cosimo Marco Fittipaldi, Mario Giorgino, Riccardo Quintarelli, Fabio Satriano, Umberto Cruciani, Alessandro Antinolfi, Vincenzo Di Berardino, Stefano Costanzo, Davide Bettini, Ranieri Mangiameli, Giuseppe Caricato, Marco Mottini, Giovanni PeerJ Cardiology BACKGROUND: Left ventricular hypertrophy (LVH) is a marker of pediatric hypertension and predicts development of cardiovascular events. Electrocardiography (ECG) screening is used in pediatrics to detect LVH thanks to major accessibility, reproducibility and easy to use compared to transthoracic echocardiography (TTE), that remains the standard technique. Several diseases were previously investigated, but no data exists regarding our study population. The aim of our study was to evaluate the relationship between electrocardiographic and echocardiographic criteria of LVH in normotensive African children. METHODS: We studied 313 children (mean age 7,8 ± 3 yo), in north-Madagascar. They underwent ECG and TTE. Sokolow-Lyon index was calculated to identify ECG-LVH (>35 mm). Left ventricle mass (LVM) with TTE was calculated and indexed by height(2.7) (LVMI(2.7)) and weight (LVMI(w)). We report the prevalence of TTE-LVH using three methods: (1) calculating percentiles age- and sex- specific with values >95th percentile identifying LVH; (2) LVMI(2.7) >51 g/m(2.7); (3) LVMI(w) >3.4 g/weight. RESULTS: 40 (13%) children showed LVMI values >95th percentile, 24 children (8%) an LVMI(2.7) >51 g/m(2.7) while 19 children (6%) an LVMI(w) >3.4 g/kg. LVH-ECG by Sokolow-Lyon index was present in five, three and three children respectively, with poor values of sensitivity (ranging from 13 to 16%), positive predictive value (from 11 to 18%) and high values of specificity (up to 92%). The effects of anthropometrics parameters on Sokolow-Lyon were analyzed and showed poor correlation. CONCLUSION: ECG is a poor screening test for detecting LVH in children. In clinical practice, TTE remains the only tool to be used to exclude LVH. PeerJ Inc. 2016-09-07 /pmc/articles/PMC5018662/ /pubmed/27651998 http://dx.doi.org/10.7717/peerj.2439 Text en ©2016 Di Gioia et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited. |
spellingShingle | Cardiology Di Gioia, Giuseppe Creta, Antonio Campanale, Cosimo Marco Fittipaldi, Mario Giorgino, Riccardo Quintarelli, Fabio Satriano, Umberto Cruciani, Alessandro Antinolfi, Vincenzo Di Berardino, Stefano Costanzo, Davide Bettini, Ranieri Mangiameli, Giuseppe Caricato, Marco Mottini, Giovanni ECG is an inefficient screening-tool for left ventricular hypertrophy in normotensive African children population |
title | ECG is an inefficient screening-tool for left ventricular hypertrophy in normotensive African children population |
title_full | ECG is an inefficient screening-tool for left ventricular hypertrophy in normotensive African children population |
title_fullStr | ECG is an inefficient screening-tool for left ventricular hypertrophy in normotensive African children population |
title_full_unstemmed | ECG is an inefficient screening-tool for left ventricular hypertrophy in normotensive African children population |
title_short | ECG is an inefficient screening-tool for left ventricular hypertrophy in normotensive African children population |
title_sort | ecg is an inefficient screening-tool for left ventricular hypertrophy in normotensive african children population |
topic | Cardiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5018662/ https://www.ncbi.nlm.nih.gov/pubmed/27651998 http://dx.doi.org/10.7717/peerj.2439 |
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