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April 1, 1996Annals of Noninvasive Electrocardiology

The sensitivity of ECG criteria for left ventricular hypertrophy was relatively low, peaking at 40.8% for Novacode LVMI in normal weight men, and deteriorated in the presence of obesity.

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Why the study?

What is the classification accuracy of various electrocardiographic criteria for left ventricular hypertrophy compared to echocardiography in normal weight and overweight older adults?

Population

2,963 older adults aged 65 and older derived from the Cardiovascular Health Study population-based sample…

Comparison

Electrocardiographic criteria for left… vs Echocardiographically measured left ventricular…

Design

Cross-sectional

Key result

The sensitivity of ECG criteria for left ventricular hypertrophy was relatively low, peaking at 40.8% for Novacode LVMI in normal weight men, and deteriorated in the presence of obesity.

Authors

PRPentti M. RautaharjuTMTeri A. ManolioDSDavid S. Siscovick

Discussion

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Overview

Supports preferring echocardiography for LVH in obese older adults; extends ECG limitation data and leaves open optimal screening strategies.

Key Points

  • To assess the diagnostic accuracy of various electrocardiographic criteria across differing severities of left ventricular hypertrophy and body weight categories in older adults.
  • Evaluated a population-based sample from the Cardiovascular Health Study of 2,963 older adults aged 65 and older (1,844 women and 1,119 men) with adequate ECG and echocardiographic data.
  • Tested Sokolow-Lyon, Cornell voltage, Cornell product, Framingham-adjusted Cornell voltage, and Novacode left ventricular mass index against echocardiographic left ventricular mass adjusted for body size.
  • With specificity set to 95%, sensitivity was generally low, peaking at 40.8% for Novacode LVMI in normal-weight men and 30.9% for Framingham criteria in normal-weight women, with both declining in obesity.
  • Cornell product and Cornell voltage criteria were the least compromised by obesity, while the Framingham obesity adjustment markedly diminished sensitivity.

Study Design

Type

Cross-Sectional (n=2,963)

Structured PICO

What is the classification accuracy of various electrocardiographic criteria for left ventricular hypertrophy compared to echocardiography in normal weight and overweight older adults?

P
Population
2,963 adults aged 65 and older with adequate quality ECGs and echocardiograms evaluated for left ventricular hypertrophy.
E
Exposure
Electrocardiographic criteria for left ventricular hypertrophy (Sokolow-Lyon, Cornell voltage, Cornell product, Framingham modification of the Cornell voltage, and Novacode ECG program LVMI).
C
Comparator
Echocardiographically measured left ventricular mass (LVM) adjusted to body size (reference standard).
O
Outcome
Classification accuracy (sensitivity and specificity) of ECG criteria for left ventricular hypertrophy.surrogate

Standard ECG criteria for left ventricular hypertrophy have low sensitivity that further deteriorates in obese patients, highlighting the limitations of relying solely on ECG for LVH screening in overweight older adults.

Cite This Study

Rautaharju et al. (1996) conducted a cross-sectional in Left ventricular hypertrophy (n=2,963). Electrocardiographic (ECG) criteria for LVH vs. Echocardiographically measured left ventricular mass was evaluated on Sensitivity of ECG criteria for LVH at 95% specificity. The sensitivity of ECG criteria for left ventricular hypertrophy was relatively low, peaking at 40.8% for Novacode LVMI in normal weight men, and deteriorated in the presence of obesity.

synapsesocial.com/papers/6a967c6c61dfe9432d01fb0chttps://doi.org/10.1111/j.1542-474x.1996.tb00271.x
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