Key result
NCRCHS criterion outperforms Cornell for detecting LVH with higher sensitivity and an AUC of ~0.74.
Why the study?
The sensitivity of ECG for detecting LVH is low, motivating the search for a better ECG screening criterion in a large general Chinese population.
Does the novel NCRCHS ECG criterion improve the detection of left ventricular hypertrophy compared to traditional ECG criteria in a general Chinese population?
Case-Control (n=10,360)
Yes
Does the novel NCRCHS ECG criterion improve the detection of left ventricular hypertrophy compared to traditional ECG criteria in a general Chinese population?
The novel NCRCHS ECG criterion demonstrates improved sensitivity and overall diagnostic performance for detecting left ventricular hypertrophy compared to traditional criteria in a Chinese population.
May enhance LVH detection sensitivity in Chinese adults; hypothesis-generating and requires prospective validation before practice change.
OBJECTIVES: The sensitivity of ECG for detecting left ventricular hypertrophy (LVH) is low. The aim of this study was to explore a better ECG criterion for screening LVH in a large general Chinese population. DESIGN: Case-control study. SETTING: China Medical University in Shenyang, China. PARTICIPANTS: All permanent residents in Dawa, Zhangwu and Liaoyang aged 35 years or older were invited. Participants with unqualified data, pacemaker rhythm, frequent premature ventricular beats, Wolff-Parkinson-White syndrome, complete bundle branch block, myocardial infarction or hypertrophic cardiomyopathy were excluded. A total of 10 360 subjects (4630 males) were recruited. INTERVENTIONS: ) was proposed and validated using multiple linear regression. Receiver-operating characteristic curves were used to compare the NCRCHS criterion with traditional criteria for LVH detection. RESULTS: 0.192, p<0.001) with the cut-off values of 36.8 mV for males and 26.1 mV for females. The maximum area under the curve was obtained using the NCRCHS criterion (male 0.74, 95% CI 0.73 to 0.75; female 0.73, 95% CI 0.72 to 0.75), followed by Cornell voltage criterion, Sokolow-Lyon criterion, Peguero-Lo Presti criterion, multi-ethnic study of atherosclerosis (MESA)-specific criterion and Syst-Eur voltage criterion. Compared with the Cornell voltage criterion, the NCRCHS criterion had a significantly higher sensitivity for detecting LVH at the same level of specificity (p<0.05). CONCLUSIONS: The NCRCHS criterion significantly improved sensitivity for LVH detection in a general Chinese population, with cut-off values of 36.8 and 26.1 mV for males and females, respectively. This criterion can detect LVH earlier and better and may prevent subsequent cardiovascular diseases.
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Chen et al. (2021) conducted a case-control in Left ventricular hypertrophy (n=10,360). NCRCHS criterion vs. Traditional criteria (e.g., Cornell voltage criterion) was evaluated on Detection of left ventricular hypertrophy (AUC 0.74 (male), 0.73 (female), 95% CI 0.73-0.75 (male), 0.72-0.75 (female), p=<0.05). The NCRCHS criterion yielded the highest AUC for detecting left ventricular hypertrophy (male 0.74, female 0.73) with significantly higher sensitivity than the Cornell criterion (p<0.05).
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