Performance of classic electrocardiographic criteria for left ventricular hypertrophy in an African population.

Details

Ressource 1Request a copy Sous embargo indéterminé.
State: Public
Version: author
Serval ID
serval:BIB_56013244AF40
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Performance of classic electrocardiographic criteria for left ventricular hypertrophy in an African population.
Journal
Hypertension
Author(s)
Jaggy C., Perret F., Bovet P., van Melle G., Zerkiebel N., Madeleine G., Kappenberger L., Paccaud F.
ISSN
0194-911X
ISSN-L
0194-911X
Publication state
Published
Issued date
2000
Peer-reviewed
Oui
Volume
36
Number
1
Pages
54-61
Language
english
Abstract
ECG criteria for left ventricular hypertrophy (LVH) have been almost exclusively elaborated and calibrated in white populations. Because several interethnic differences in ECG characteristics have been found, the applicability of these criteria to African individuals remains to be demonstrated. We therefore investigated the performance of classic ECG criteria for LVH detection in an African population. Digitized 12-lead ECG tracings were obtained from 334 African individuals randomly selected from the general population of the Republic of Seychelles (Indian Ocean). Left ventricular mass was calculated with M-mode echocardiography and indexed to body height. LVH was defined by taking the 95th percentile of body height-indexed LVM values in a reference subgroup. In the entire study sample, 16 men and 15 women (prevalence 9.3%) were finally declared to have LVH, of whom 9 were of the reference subgroup. Sensitivity, specificity, accuracy, and positive and negative predictive values for LVH were calculated for 9 classic ECG criteria, and receiver operating characteristic curves were computed. We also generated a new composite time-voltage criterion with stepwise multiple linear regression: weighted time-voltage criterion=(0.2366R(aVL)+0.0551R(V5)+0.0785S(V3)+ 0.2993T(V1))xQRS duration. The Sokolow-Lyon criterion reached the highest sensitivity (61%) and the R(aVL) voltage criterion reached the highest specificity (97%) when evaluated at their traditional partition value. However, at a fixed specificity of 95%, the sensitivity of these 10 criteria ranged from 16% to 32%. Best accuracy was obtained with the R(aVL) voltage criterion and the new composite time-voltage criterion (89% for both). Positive and negative predictive values varied considerably depending on the concomitant presence of 3 clinical risk factors for LVH (hypertension, age >/=50 years, overweight). Median positive and negative predictive values of the 10 ECG criteria were 15% and 95%, respectively, for subjects with none or 1 of these risk factors compared with 63% and 76% for subjects with all of them. In conclusion, the performance of classic ECG criteria for LVH detection was largely disparate and appeared to be lower in this population of East African origin than in white subjects. A newly generated composite time-voltage criterion might provide improved performance. The predictive value of ECG criteria for LVH was considerably enhanced with the integration of information on concomitant clinical risk factors for LVH.
Keywords
Adult, Africa, Electrocardiography, Female, Humans, Hypertrophy, Left Ventricular, Male, Middle Aged
Pubmed
Web of science
Create date
14/03/2008 11:21
Last modification date
20/08/2019 15:10
Usage data