Key result
SAECG time domain integral >8 detected incipient left ventricular hypertrophy in 56.5% of hypertensive patients with normal ECG/echo versus 18.4% of healthy controls (p<0.0005).
Why the study?
Can signal-averaged electrocardiogram (SAECG) detect incipient left ventricular hypertrophy in patients with mild to moderate hypertension and normal standard ECG and echocardiogram?
Cross-Sectional (n=115)
Can signal-averaged electrocardiogram (SAECG) detect incipient left ventricular hypertrophy in patients with mild to moderate hypertension and normal standard ECG and echocardiogram?
SAECG may be a useful tool for the early diagnosis of left ventricular hypertrophy in hypertensive patients who have normal standard ECG and echocardiogram findings.
May aid early LVH detection in mild hypertension; hypothesis-generating for prospective validation before clinical adoption.
OBJECTIVE: To assess signal-averaged electrocardiogram (SAECG) for diagnosing incipient left ventricular hypertrophy (LVH). METHODS: A study with 115 individuals was carried out. The individuals were divided as follows: GI - 38 healthy individuals; GII - 47 individuals with mild to moderate hypertension and normal findings on echocardiogram and ECG; and GIII - 30 individuals with hypertension and documented LVH. The magnitude vector of the SAECG was analyzed with the high-pass cutoff frequency of 40 Hz through the bidirectional four-pole Butterworth high-pass digital filter. The mean quadratic root of the total QRS voltage (RMST) and the two-dimensional integral of the QRS area of the spectro-temporal map were analyzed between 0 and 30 Hz for the frequency domain (Int FD), and between 40 and 250 Hz for the time domain (Int TD). The electrocardiographic criterion for LVH was based on the Cornell Product. Left ventricular mass was calculated with the Devereux formula. RESULTS: All parameters analyzed increased from GI to GIII, except for Int FD (GII vs GIII) and RMST log (GII vs GIII). Int TD showed greater accuracy for detecting LVH with an appropriate cutoff > 8 (sensitivity of 55%, specificity of 81%). Positive values (> 8) were found in 56.5% of the G II patients and in 18.4% of the GI patients (p< 0.0005). CONCLUSION: SAECG can be used in the early diagnosis of LVH in hypertensive patients with normal ECG and echocardiogram.
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Ginefra et al. (2003) conducted a cross-sectional in mild to moderate arterial hypertension (n=115). Signal-averaged electrocardiogram (SAECG) vs. Healthy individuals was evaluated on Detection of incipient LVH using Int TD > 8 (p=< 0.0005). SAECG time domain integral >8 detected incipient left ventricular hypertrophy in 56.5% of hypertensive patients with normal ECG/echo versus 18.4% of healthy controls (p<0.0005).
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