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Prediction of stroke with electrocardiographic left ventricular hypertrophy in hypertensive patients: A meta-analysis

Song Yi1, Fang Wang2, Minna Wan3

  • 1Department of Cardiovascular Ward 2, The people's hospital of Yichun city, Yichun, Jiangxi Province 336000, China.

Journal of Electrocardiology
|June 7, 2020
PubMed

Insights

Electrocardiographic left ventricular hypertrophy (LVH) detected by Sokolow-Lyon or Cornell voltage criteria predicts stroke risk in hypertensive patients. This method can improve stroke risk stratification.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Stroke Prevention

Background:

  • Electrocardiographic left ventricular hypertrophy (LVH) is a known predictor of adverse outcomes in hypertensive individuals.
  • Various electrocardiographic criteria exist for diagnosing LVH, each potentially varying in predictive accuracy.

Purpose of the Study:

  • To meta-analyze the association between different electrocardiographic LVH criteria and stroke risk in hypertensive patients.
  • To evaluate the utility of electrocardiographic LVH in improving stroke risk stratification.

Main Methods:

  • A comprehensive literature search was conducted on PubMed and Embase databases.
  • Seven observational studies involving 58,098 hypertensive patients were included.
  • Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated for stroke risk associated with LVH by Cornell voltage, Cornell product, and Sokolow-Lyon voltage criteria.

Main Results:

  • Electrocardiographic LVH was associated with an increased risk of stroke: RR 1.63 (95% CI 1.38-1.93) for Cornell voltage, RR 1.41 (95% CI 1.07-1.86) for Cornell product, and RR 1.42 (95% CI 1.20-1.69) for Sokolow-Lyon voltage.
  • Sensitivity analysis indicated that the predictive significance of the Cornell product criteria was not reliable.
  • Sokolow-Lyon and Cornell voltage criteria demonstrated reliable predictive value for stroke development.

Conclusions:

  • Baseline electrocardiographic LVH, particularly when detected by Sokolow-Lyon or Cornell voltage criteria, can predict stroke development in hypertensive patients.
  • Incorporating electrocardiographic LVH assessment can enhance the accuracy of stroke risk stratification in this population.
Abstract

Keywords:
Cornell productCornell voltageHypertensionLeft ventricular hypertrophyMeta-analysisSokolow-LyonStroke

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