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Standard electrocardiographic criteria for left ventricular hypertrophy in Nigerian hypertensives

Adekola Dada1, Adewole A Adebiyi, Akinyemi Aje

  • 1Department of Medicine, University College Hospital, University of Ibadan, Nigeria.

Ethnicity & Disease
|November 2, 2005
PubMed

Insights

The Sokolow-Lyon and Sokolow-Lyon-Rappaport voltage criteria demonstrate superior sensitivity and specificity for diagnosing left ventricular hypertrophy (LVH) in Nigerian hypertensive patients, outperforming other electrocardiogram methods.

Area of Science:

  • Cardiology
  • Medical Diagnostics
  • Public Health

Background:

  • Left ventricular hypertrophy (LVH) is a significant predictor of cardiovascular events.
  • Existing electrocardiogram (ECG) criteria for LVH detection vary in accuracy and have limited validation in diverse populations.
  • The African population's unique characteristics necessitate evaluation of ECG criteria for LVH.

Purpose of the Study:

  • To assess the diagnostic performance of various ECG criteria for LVH in a Nigerian population.
  • To compare the sensitivity and specificity of different ECG criteria against echocardiographic findings.
  • To identify the most suitable ECG criteria for LVH diagnosis in Nigerians.

Main Methods:

  • Obtained ECGs and echocardiograms from 100 hypertensive patients and 60 controls.
  • Assessed LVH using Sokolow-Lyon, Sokolow-Lyon-Rappaport, Cornell voltage, Romhilt-Estes, and Perugia score criteria.
  • Defined echocardiographic LVH based on LV mass indexed for height relative to control percentiles.

Main Results:

  • Prevalence of echocardiographic LVH was 34% in hypertensive patients and 1.67% in controls.
  • ECG criteria revealed LVH prevalence ranging from 18% (Romhilt-Estes) to 56% (Sokolow-Lyon-Rappaport).
  • Sokolow-Lyon-Rappaport showed the highest sensitivity (80%), while Romhilt-Estes had the best specificity (93%).

Conclusions:

  • Sokolow-Lyon and Sokolow-Lyon-Rappaport voltage criteria offer a balanced combination of sensitivity and specificity.
  • These criteria appear most appropriate for diagnosing ECG-detected LVH in the Nigerian population.
  • Further validation in larger, diverse African cohorts is recommended.
Abstract

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