Why the study?
Left ventricular hypertrophy is a strong predictor of cardiovascular disease and mortality, but diagnostic means in resource-constrained settings remain limited.
Does electrocardiography accurately detect left ventricular hypertrophy compared to transthoracic echocardiography in high-risk Haitian adults?
Does electrocardiography accurately detect left ventricular hypertrophy compared to transthoracic echocardiography in high-risk Haitian adults?
In a high-risk Haitian cohort, LVH prevalence by echocardiography was high (39%), but standard ECG criteria had very low sensitivity (<10%) for detecting it, suggesting ECG is inadequate for LVH screening in this population.
Answers are grounded in this paper and cite their sources.
ECG underperforms for LVH detection versus TTE in high-risk Haitian adults; leaves open whether TTE screening improves outcomes in resource-limited settings.
Left ventricular hypertrophy (LVH) is one of the strongest predictors of cardiovascular disease (CVD) and mortality; yet the means to diagnose LVH in resource-constrained settings remain limited. The objectives of this study were to determine LVH prevalence by transthoracic echocardiography (TTE) in a high-risk group, and compare TTE vs. electrocardiography (ECG-LVH) for LVH detection. We analyzed enrollment data from the Haiti cardiovascular disease cohort study on adults (≥ 18 years, n = 3,005) in Port-au-Prince between 2019 and 2021. All participants underwent questionnaires, vital signs, physical exams, and 12-lead ECGs. TTEs were acquired on those with hypertension or exhibiting CVD symptoms (n = 1040, 34.7%). TTE-LVH was defined according to the American Society of Echocardiography guidelines and ECG-LVH by Sokolow-Lyon, Cornell, and Limb-Lead Voltage criteria. The prevalence of TTE-LVH was 39.0% (95% CI 36.6-41.5%) and associated with older age. Only 26% of those with TTE-LVH and elevated blood pressure were on antihypertensives. Prevalence of ECG-LVH ranged from 1.9 to 5.0%, and compared to TTE-LVH had low agreement (κ < 0.20), low sensitivity (< 10%) and high specificity (> 90%). These findings indicate a high prevalence of TTE-LVH among high-risk Haitian adults, and poor detection using ECGs compared to TTEs. For those with TTE-LVH, treatment with antihypertensives may reduce the risk of adverse CVD outcomes.
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Ogyu et al. (2025) studied this question.
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