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Optimized electrocardiographic criteria for the detection of left ventricular hypertrophy in obesity patients

BACKGROUND: Despite a generally high specificity, electrocardiographic (ECG) criteria for the detection of left ventricular hypertrophy (LVH) lack sensitivity, particularly in obesity patients. OBJECTIVES: The aim of the study was to evaluate the accuracy of the most commonly used ECG criteria (Corn...

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Autores principales: Snelder, Sanne M., van de Poll, Sweder W.E., de Groot – de Laat, Lotte E., Kardys, Isabella, Zijlstra, Felix, van Dalen, Bas M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wiley Periodicals, Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244296/
https://www.ncbi.nlm.nih.gov/pubmed/31990994
http://dx.doi.org/10.1002/clc.23333
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author Snelder, Sanne M.
van de Poll, Sweder W.E.
de Groot – de Laat, Lotte E.
Kardys, Isabella
Zijlstra, Felix
van Dalen, Bas M.
author_facet Snelder, Sanne M.
van de Poll, Sweder W.E.
de Groot – de Laat, Lotte E.
Kardys, Isabella
Zijlstra, Felix
van Dalen, Bas M.
author_sort Snelder, Sanne M.
collection PubMed
description BACKGROUND: Despite a generally high specificity, electrocardiographic (ECG) criteria for the detection of left ventricular hypertrophy (LVH) lack sensitivity, particularly in obesity patients. OBJECTIVES: The aim of the study was to evaluate the accuracy of the most commonly used ECG criteria (Cornell voltage and Sokolow‐Lyon index), the recently introduced Peguero‐Lo Presti criteria and the correction of these criteria by body mass index (BMI) to detect LVH in obesity patients and to propose adjusted ECG criteria with optimal accuracy. METHODS: The accuracy of the ECG criteria for the detection of LVH was retrospectively tested in a cohort of obesity patients referred for a transthoracic echocardiogram based on clinical grounds (test cohort, n = 167). Adjusted ECG criteria with optimal sensitivity for the detection of LVH were developed. Subsequently, the value of these criteria was prospectively tested in an obese population without known cardiovascular disease (validation cohort, n = 100). RESULTS: Established ECG criteria had a poor sensitivity in obesity patients in both the test cohort and the validation cohort. The adjusted criteria showed improved sensitivity, with optimal values for males using the Cornell voltage corrected for BMI, (RaVL+SV3)*BMI ≥700 mm*kg/m(2); sensitivity 47% test cohort, 40% validation cohort; for females, the Sokolow‐Lyon index corrected for BMI, (SV1 + RV5/RV6)*BMI ≥885 mm*kg/m(2); sensitivity 26% test cohort, 23% validation cohort. CONCLUSIONS: Established ECG criteria for the detection of LVH lack sufficient sensitivity in obesity patients. We propose new criteria for the detection of LVH in obesity patients with improved sensitivity, approaching known sensitivity of the most commonly used ECG criteria in lean subjects.
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spelling pubmed-72442962020-06-01 Optimized electrocardiographic criteria for the detection of left ventricular hypertrophy in obesity patients Snelder, Sanne M. van de Poll, Sweder W.E. de Groot – de Laat, Lotte E. Kardys, Isabella Zijlstra, Felix van Dalen, Bas M. Clin Cardiol Clinical Investigations BACKGROUND: Despite a generally high specificity, electrocardiographic (ECG) criteria for the detection of left ventricular hypertrophy (LVH) lack sensitivity, particularly in obesity patients. OBJECTIVES: The aim of the study was to evaluate the accuracy of the most commonly used ECG criteria (Cornell voltage and Sokolow‐Lyon index), the recently introduced Peguero‐Lo Presti criteria and the correction of these criteria by body mass index (BMI) to detect LVH in obesity patients and to propose adjusted ECG criteria with optimal accuracy. METHODS: The accuracy of the ECG criteria for the detection of LVH was retrospectively tested in a cohort of obesity patients referred for a transthoracic echocardiogram based on clinical grounds (test cohort, n = 167). Adjusted ECG criteria with optimal sensitivity for the detection of LVH were developed. Subsequently, the value of these criteria was prospectively tested in an obese population without known cardiovascular disease (validation cohort, n = 100). RESULTS: Established ECG criteria had a poor sensitivity in obesity patients in both the test cohort and the validation cohort. The adjusted criteria showed improved sensitivity, with optimal values for males using the Cornell voltage corrected for BMI, (RaVL+SV3)*BMI ≥700 mm*kg/m(2); sensitivity 47% test cohort, 40% validation cohort; for females, the Sokolow‐Lyon index corrected for BMI, (SV1 + RV5/RV6)*BMI ≥885 mm*kg/m(2); sensitivity 26% test cohort, 23% validation cohort. CONCLUSIONS: Established ECG criteria for the detection of LVH lack sufficient sensitivity in obesity patients. We propose new criteria for the detection of LVH in obesity patients with improved sensitivity, approaching known sensitivity of the most commonly used ECG criteria in lean subjects. Wiley Periodicals, Inc. 2020-01-28 /pmc/articles/PMC7244296/ /pubmed/31990994 http://dx.doi.org/10.1002/clc.23333 Text en © 2020 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Investigations
Snelder, Sanne M.
van de Poll, Sweder W.E.
de Groot – de Laat, Lotte E.
Kardys, Isabella
Zijlstra, Felix
van Dalen, Bas M.
Optimized electrocardiographic criteria for the detection of left ventricular hypertrophy in obesity patients
title Optimized electrocardiographic criteria for the detection of left ventricular hypertrophy in obesity patients
title_full Optimized electrocardiographic criteria for the detection of left ventricular hypertrophy in obesity patients
title_fullStr Optimized electrocardiographic criteria for the detection of left ventricular hypertrophy in obesity patients
title_full_unstemmed Optimized electrocardiographic criteria for the detection of left ventricular hypertrophy in obesity patients
title_short Optimized electrocardiographic criteria for the detection of left ventricular hypertrophy in obesity patients
title_sort optimized electrocardiographic criteria for the detection of left ventricular hypertrophy in obesity patients
topic Clinical Investigations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244296/
https://www.ncbi.nlm.nih.gov/pubmed/31990994
http://dx.doi.org/10.1002/clc.23333
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