[Routine electrocardiographic criteria for the diagnosis of left ventricular hypertrophy: performance in Black
A Niakara1, N Ouédraogo, L V A Nébié
1Service de cardiologie, centre hospitalier national Yalgado Ouédraogo (CHNYO), BP 3401, Ouagadougou, Burkina Faso. niakaraali@yahoo.fr
Insights
Routine electrocardiographic (ECG) criteria show poor performance for diagnosing left ventricular hypertrophy (LVH) in Black Africans. New, improved ECG criteria are needed for accurate LVH diagnosis in this population.
Area of Science:
- Cardiology
- Medical Diagnostics
Background:
- Left ventricular hypertrophy (LVH) is a significant cardiac condition.
- Accurate diagnosis of LVH is crucial for effective patient management.
- Existing electrocardiographic (ECG) criteria require evaluation in diverse populations.
Purpose of the Study:
- To assess the diagnostic performance of standard ECG criteria for LVH in Black Africans.
- To compare the sensitivity, specificity, and predictive values of different ECG criteria.
Main Methods:
- Echocardiography and 12-lead ECG were performed on 154 patients and 30 healthy controls.
- Evaluated Lewis, Sokolow, and Cornell (S1 and S2) ECG criteria for LVH diagnosis.
- Calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
Main Results:
- Prevalence of LVH varied from 15.6% to 35.7% based on ECG criteria.
- Sensitivities ranged from 0.19 (Lewis) to 0.76 (Cornell S1).
- Specificities ranged from 0.54 (Cornell S2) to 0.91 (Cornell S1). PPV and NPV varied significantly across criteria.
Conclusions:
- Standard ECG criteria demonstrate low diagnostic performance for LVH in Black Africans.
- There is a critical need for developing and validating novel ECG criteria tailored for this demographic.
- Improved diagnostic tools are essential for better clinical outcomes.
Objective:
To determine, in Black Africans, the performance of routine electrocardiographic criteria in the diagnosis of left ventricular hypertrophy (LVH).
Methods:
Thirty voluntary healthy subjects and 154 patients were explored at echocardiography (according to Pen convention) and 12-lead electrocardiography (ECG). The performance of Lewis, Sokolow and Cornell (Cornell S1 for a threshold of 28 mm in men, and Cornell S2, for a threshold of 24 mm) criteria were defined by their sensitivity, specificity, positive and negative predictive values.
Results:
The prevalence of LVH in the 154 patients ranged from 15.6% to 35.7%, according to the ECG criteria. Sensitivities were of 0.19, 0.43, 0.30 and 0.76 for the Lewis, Sokolow, Cornell S1 respectively, and the specificities were of 0.89, 0.73, 0.91 and 0.54. Positive predictive value ranged from 0.16 (Cornell S2) to 0.91 (Cornell S2), and the negative predictive value, from 0.48 (Lewis) to 0.86 (Cornell S2).
Conclusion:
Routine ECG criteria for the diagnosis LVH have low performance in Black African. There is a need of new ECG criteria with better performance.
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