Clinical applicability and diagnostic performance of electrocardiographic criteria for left ventricular hypertrophy diagnosis in older adults

Figures

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  Figure 1. Study flowchart. ECG electrocardiography; ICU intensive care unit; LBBB left bundle branch block; RBBB right bundle branch block.

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  Figure 2. ROC curve and AUC for all ECG evaluated criteria. AUC of the ECG criteria, using the echocardiogram as the reference for LVH. All criteria were compared against the Peguero-Lo Presti criterion. AUC area under the curve; CI Confidence Interval; Ref reference.

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  Figure 3. Decision curve analysis for the ECG criteria. Decision curve analysis showing the effect of ECG criteria on the detection of left ventricular hypertrophy as assessed by echocardiogram. Net benefit is plotted against the risk threshold at which the clinician would opt for ordering echocardiogram, compared to strategies of performing echocardiogram to all patients (black line) or none (grey line) (a). (b) Shows the net reduction in echocardiograms ordered by using different ECG criteria (as shown in the number of unnecessary echocardiograms avoided per 100 patients). Probability threshold range (0.1–0.6) reflect different relative values for harm (performing an echocardiogram in patients without LVH, i.e., false positives) and benefit (identifying a true positive) and were selected a priori to mimic both high (0.1–0.3) and under-resourced (0.3–0.6) theoretical clinical scenarios where elective echocardiogram availability and waiting times are supposed to vary.