Key result
ECG criteria for LVH show high specificity but low sensitivity that drops with higher BMI.
Why the study?
Presence of LVH increases cardiovascular risk, but high BMI may reduce ECG amplitudes, affecting the diagnostic performance of ECG criteria.
Does high body mass index reduce the diagnostic sensitivity and specificity of electrocardiographic criteria for left ventricular hypertrophy compared to cardiac magnetic resonance imaging?
Cross-Sectional (n=1,882)
Does high body mass index reduce the diagnostic sensitivity and specificity of electrocardiographic criteria for left ventricular hypertrophy compared to cardiac magnetic resonance imaging?
ECG criteria for left ventricular hypertrophy have high specificity but low sensitivity, and this sensitivity further decreases in patients with higher body mass index.
ECG sensitivity for LVH falls with higher BMI; leaves open validation of adjusted criteria versus CMR.
BACKGROUND: Presence of left ventricular hypertrophy (LVH) increases the risk for cardiovascular event. Many electrocardiographic (ECG) criteria can be used to diagnose LVH; however, high body mass index (BMI) may reduce ECG amplitudes.The aim of this study was to investigate the diagnostic performance of ECG criteria for diagnosing LVH among various BMI groups compared to diagnosis by cardiac magnetic resonance (CMR) imaging. METHODS: ). RESULTS: Of the 1,882 patients that were included, 67 were underweight, 459 were normal weight, 434 were overweight, and 922 were obese. LVH was diagnosed in 34 (50.7%) underweight, 144 (31.4%) normal weight, 100 (23.0%) overweight, and 181 (19.6%) obese patients. Overall specificity of ECG was high (0.89-0.95), and overall sensitivity was low (0.25-0.37). The specificity of each ECG criterion was similar among BMI groups; however, the sensitivity of ECG criteria demonstrated a decreasing trend in the higher BMI groups. CONCLUSION: All ECG criteria demonstrated relatively high specificity and relatively low sensitivity. Although the specificity across groups remained similar, higher BMI was found to be associated with decreased sensitivity.
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Nomsawadi et al. (2019) conducted a cross-sectional in Left ventricular hypertrophy (n=1,882). Electrocardiographic (ECG) criteria vs. Cardiac magnetic resonance (CMR) imaging was evaluated on Diagnostic performance (sensitivity and specificity) for left ventricular hypertrophy. Electrocardiographic criteria for diagnosing left ventricular hypertrophy showed high overall specificity (0.89-0.95) but low sensitivity (0.25-0.37), with sensitivity decreasing in higher BMI groups.
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