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Electrocardiography Diagnostic Performance for Left Ventricular Hypertrophy During Arterial Hypertension on African
Ella Hatoula Lengani1, Jonas Koudougou Kologo2,3, Aristide Relwende Yameogo2
1Bogodogo University Hospital Center Cardiology Department Ouagadougou Burkina Faso.
Insights
Electrocardiography (ECG) shows poor diagnostic performance for left ventricular hypertrophy (LVH) in hypertensive patients. Further research is needed to develop new ECG clues for improved detection of LVH in hypertension.
Area of Science:
- Cardiology
- Medical Diagnostics
- Hypertension Research
Background:
- Left ventricular hypertrophy (LVH) is a common complication and predictor of cardiovascular risk in hypertension.
- Current diagnosis relies on electrocardiography (ECG) and Doppler echocardiography.
Purpose of the Study:
- To determine the diagnostic performance of ECG for LVH in hypertensive patients within an African context.
Main Methods:
- A descriptive, analytical cross-sectional study was conducted.
- Seven electrical indices were evaluated against Doppler echocardiography.
- Performance metrics included sensitivity, specificity, PPV, NPV, and AUC.
Main Results:
- 213 hypertensive patients were included (mean age 54, 31% obesity, 30% renal failure).
- ECG sensitivity ranged from 4.3% to 34.8%, while specificity ranged from 87.4% to 99.4%.
- The MacPhie index demonstrated the best performance with an AUC of 0.638.
Conclusions:
- ECG exhibits poor diagnostic performance for LVH in hypertensive individuals.
- Novel ECG-based strategies are required to enhance LVH detection accuracy.
Introduction:
Left ventricular hypertrophy (LVH) is the earliest and most common complication during hypertension. It is also a powerful predictor of cardiovascular risk. In current practice, electrocardiography (ECG) and Doppler echocardiography are the tools used for the diagnosis of LVH during arterial hypertension.
Objective:
Determine the electrical diagnostic performance of LVH during arterial hypertension on african context.
Methods:
We conducted a descriptive and analytical cross-sectional study that took place from April 1 to July 10, 2017 in the cardiology department of the CHU/YO. Hypertensive patients were systematically included in our study. The performance of seven (07) electrical indices was evaluated by sensitivity, specificity, positive and negative predictive value, and area under the curve with reference to Doppler echocardiography.
Results:
213 patients were included in the study. The sex ratio was 0.46 with a mean age of 54 years. Obesity was noted in 31% of cases, and renal failure in 30% of cases. The hypertension was controlled in 39% of patients. The prevalence of hypertension on echocardiography was 22%. The electrical sensitivity of the indices ranged from 4.3% to 34.8%. Specificity ranged from 87.4% to 99.4%. PPV ranged from 28.6% to 83.3% and NPV from 78.6% to 83.8%. The MacPhie index had the best diagnostic performance with an AUC of 0.638.
Conclusion:
The ECG has a poor performance in the diagnosis of LVH in hypertensive subjects. Research should focus on modeling new clues to improve the diagnostic performance of the ECG.
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