Performance of electrocardiographic criteria for detecting LVH in hypertensive Africans

Area of Science:

• Cardiology
• Medical Diagnostics
• Electrocardiography

Background:

• Left ventricular hypertrophy (LVH) is a significant risk factor for cardiovascular events.
• Accurate diagnosis of LVH is crucial for timely intervention and management.
• Existing electrocardiographic (ECG) criteria for LVH may have varying diagnostic performance across different ethnic groups.

Purpose of the Study:

• To evaluate the diagnostic performance of established LVH electrocardiographic (ECG) criteria using ethnic-specific normal values.
• To identify the most accurate ECG criterion for diagnosing LVH in a hypertensive African population.

Main Methods:

• A cohort of 309 hypertensive subjects underwent both 12-lead ECG and echocardiographic analysis.
• Echocardiography, utilizing ethnic-specific norms, served as the gold standard for LVH diagnosis.
• Performance of standard ECG criteria (Sokolow-Lyon, Peguero-Lo Presti, Cornell voltage, Cornell Product) was assessed using Area Under the Curve (AUC).

Main Results:

• Current ECG criteria demonstrated low overall performance in diagnosing LVH.
• The Area Under Curve (AUC) values were 0.61 for Sokolow-Lyon, 0.65 for Peguero-Lo Presti, 0.72 for Cornell voltage, and 0.71 for Cornell Product.
• Cornell voltage exhibited the highest diagnostic accuracy among the evaluated ECG criteria.

Conclusions:

• Standard ECG criteria for LVH diagnosis have limited accuracy in hypertensive African individuals.
• The Cornell voltage criterion is the most effective ECG method for identifying LVH in this specific demographic.
• Further research may be warranted to refine ECG criteria for LVH detection in diverse ethnic populations.