Key result
ECG indices yield poor sensitivity but high specificity for diagnosing LVH in African hypertensive patients.
Why the study?
Left ventricular hypertrophy is the most common complication of hypertension and predicts cardiovascular risk, but data on electrocardiography diagnostic performance in an African context were needed.
Does electrocardiography accurately diagnose left ventricular hypertrophy compared to Doppler echocardiography in hypertensive patients?
Does electrocardiography accurately diagnose left ventricular hypertrophy compared to Doppler echocardiography in hypertensive patients?
ECG has poor sensitivity but high specificity for diagnosing left ventricular hypertrophy in hypertensive African patients, indicating it is insufficient as a standalone diagnostic tool.
Should not rely on ECG alone for LVH in African patients with hypertension; extends known diagnostic limitations to this population.
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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Lengani et al. (2026) studied this question. Seven electrocardiography indices demonstrated poor sensitivity (4.3%-34.8%) but high specificity (87.4%-99.4%) for diagnosing left ventricular hypertrophy in African hypertensive patients.
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