Key result
The newly proposed SD + SV4 ECG criterion demonstrated higher diagnostic accuracy for left ventricular hypertrophy (AUC 0.765) compared to traditional criteria in a Chinese population.
Why the study?
Studies in small hypertensive samples suggested the newly proposed SD + SV4 electrocardiogram criterion for LVH outperforms traditional criteria, but verification in a Chinese population with or without hypertension and analysis of factors affecting diagnostic accuracy were needed.
Does the SD + SV4 ECG criterion improve diagnostic accuracy for left ventricular hypertrophy compared to traditional criteria in a Chinese population?
Observational (n=248)
No
Does the SD + SV4 ECG criterion improve diagnostic accuracy for left ventricular hypertrophy compared to traditional criteria in a Chinese population?
The newly proposed SD + SV4 ECG criterion offers improved sensitivity and accuracy for diagnosing left ventricular hypertrophy compared to traditional criteria, though its accuracy is independently affected by decreased left ventricular ejection fraction.
Introduction: Based on a small sample of patients with hypertension, a few studies have reported that the newly proposed SD + SV₄ criterion for left ventricular hypertrophy (LVH) is better than traditional criteria. This study aimed to verify the diagnostic capability of the SD + SV₄ criterion in a Chinese population with or without hypertension and to analyze the factors affecting the diagnostic accuracy of LVH. Methods: A total of 248 patients with LVH or paroxysmal supraventricular tachycardia (PSVT) discharged from Fuwai Hospital from January 2010 to July 2018 were enrolled. Patients with LVH were diagnosed according to the left ventricular mass index calculated by the echocardiogram parameter as the gold standard in this study. The receiver operating curve (ROC) curve was performed to assess the diagnostic capability and cut-off values of the SD + SV₄, RavL + SV₃, and SV₁ + RV₅/RV₆ criteria for LVH. Then, multivariate logistic regression analyses were performed to investigate the factors affecting the accuracy of the SD + SV₄ criterion. Results: There were 170 (68.5%) patients with hypertension and 110 (44.4%) with PSVT. According to echocardiography, 107 (43.1%) patients were diagnosed with LVH. The area under the curve (AUC) of the SD + SV₄ criterion was the largest compared with that of the RavL + SV₃ and SV₁ + RV₅/RV₆ criteria (AUC 0.765 vs. 0.718 vs. 0.713, respectively). The sex-specific SD + SV₄ criterion had the highest consistency with the gold standard (r = 0.532 ± 0.054, p < 0.01), accompanied by the highest sensitivity (70.1%) and specificity (85.8%). The cut-off values of the sex-specific SD + SV₄ criterion for LVH were ≥2.65 mV (male)/2.15 mV (female). The left ventricular ejection fraction (LVEF; OR 0.920, 95% CI 0.882–0.959, p < 0.001) was significantly different between the SD + SV₄ criterion and the gold standard for LVH after adjusting for hypertension, PSVT history, body surface area, interventricular septum thickness, posterior wall thickness, and left ventricular internal diameter. Conclusion: The newly proposed SD + SV₄ criterion provides improved sensitivity and accuracy for the diagnosis of LVH in the Chinese population. A decrease in LVEF is an independent factor affecting the diagnostic accuracy of LVH.
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Xia et al. (2020) conducted an observational in Left ventricular hypertrophy or paroxysmal supraventricular tachycardia (n=248). SD + SV4 ECG criterion vs. RavL + SV3 and SV1 + RV5/RV6 criteria was evaluated on Diagnostic capability for left ventricular hypertrophy (Area Under the Curve) (AUC 0.765, p=<0.01). The newly proposed SD + SV4 ECG criterion demonstrated higher diagnostic accuracy for left ventricular hypertrophy (AUC 0.765) compared to traditional criteria in a Chinese population.
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