Open AccessOptimized electrocardiographic criteria for the detection of left ventricular hypertrophy in obesity patients
Author(s) -
Snelder Sanne M.,
Poll Sweder W.E.,
Groot – de Laat Lotte E.,
Kardys Isabella,
Zijlstra Felix,
Dalen Bas M.
Publication year - 2020
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.23333
Subject(s) - medicine , cohort , left ventricular hypertrophy , body mass index , cardiology , population , prospective cohort study , cohort study , blood pressure , environmental health
Background Despite a generally high specificity, electrocardiographic (ECG) criteria for the detection of left ventricular hypertrophy (LVH) lack sensitivity, particularly in obesity patients. Objectives The aim of the study was to evaluate the accuracy of the most commonly used ECG criteria (Cornell voltage and Sokolow‐Lyon index), the recently introduced Peguero‐Lo Presti criteria and the correction of these criteria by body mass index (BMI) to detect LVH in obesity patients and to propose adjusted ECG criteria with optimal accuracy. Methods The accuracy of the ECG criteria for the detection of LVH was retrospectively tested in a cohort of obesity patients referred for a transthoracic echocardiogram based on clinical grounds (test cohort, n = 167). Adjusted ECG criteria with optimal sensitivity for the detection of LVH were developed. Subsequently, the value of these criteria was prospectively tested in an obese population without known cardiovascular disease (validation cohort, n = 100). Results Established ECG criteria had a poor sensitivity in obesity patients in both the test cohort and the validation cohort. The adjusted criteria showed improved sensitivity, with optimal values for males using the Cornell voltage corrected for BMI, (RaVL+SV3)*BMI ≥700 mm*kg/m 2 ; sensitivity 47% test cohort, 40% validation cohort; for females, the Sokolow‐Lyon index corrected for BMI, (SV1 + RV5/RV6)*BMI ≥885 mm*kg/m 2 ; sensitivity 26% test cohort, 23% validation cohort. Conclusions Established ECG criteria for the detection of LVH lack sufficient sensitivity in obesity patients. We propose new criteria for the detection of LVH in obesity patients with improved sensitivity, approaching known sensitivity of the most commonly used ECG criteria in lean subjects.