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ECG is an inefficient screening-tool for left ventricular hypertrophy in normotensive African children population

Giuseppe Di Gioia1, Antonio Creta1, Cosimo Marco Campanale1

  • 1Department of Medicine and Surgery, Unit of Cardiology, Campus Bio-Medico University of Rome , Rome , Italy.

Peerj
|September 22, 2016
PubMed

Insights

Electrocardiography (ECG) is not a reliable screening tool for left ventricular hypertrophy (LVH) in African children. Transthoracic echocardiography (TTE) remains the definitive diagnostic method for LVH in this population.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Health
  • Diagnostic Imaging

Background:

  • Left ventricular hypertrophy (LVH) is a critical indicator of pediatric hypertension and a predictor of future cardiovascular events.
  • Electrocardiography (ECG) is widely used for LVH screening in children due to its accessibility and ease of use, contrasting with transthoracic echocardiography (TTE), the established gold standard.
  • Limited data exists on LVH detection using ECG and TTE in African children.

Purpose of the Study:

  • To investigate the correlation between electrocardiographic (ECG) and echocardiographic (TTE) criteria for diagnosing left ventricular hypertrophy (LVH).
  • To assess the effectiveness of ECG screening for LVH in normotensive African children.

Main Methods:

  • A study involving 313 children in North Madagascar, utilizing both ECG and TTE.
  • Calculation of the Sokolow-Lyon index for ECG-defined LVH and Left Ventricle Mass indexed by height (LVMI(2.7)) and weight (LVMI(w)) via TTE.
  • Prevalence of TTE-LVH determined using age- and sex-specific percentiles (>95th), LVMI(2.7) >51 g/m(2.7), and LVMI(w) >3.4 g/kg.

Main Results:

  • Prevalence of LVH by TTE varied: 13% (LVMI percentiles), 8% (LVMI(2.7)), and 6% (LVMI(w)).
  • ECG-LVH (Sokolow-Lyon index) was detected in a small number of children, exhibiting low sensitivity (13-16%) and positive predictive value (11-18%), but high specificity (up to 92%).
  • Anthropometric parameters showed a weak correlation with the Sokolow-Lyon index.

Conclusions:

  • Electrocardiography (ECG) demonstrates poor performance as a screening tool for left ventricular hypertrophy (LVH) in children.
  • Transthoracic echocardiography (TTE) is essential for accurately excluding LVH in pediatric clinical practice.
Abstract

Keywords:
African childrenECGScreeningVentricular hypertrophy

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