ECG sensitivity for detecting echocardiographic LVH in Tanzanian adults was low, with Sokolow-Lyon performing better in men (43.8%) and Cornell product performing better in women (60%).
Cross-Sectional (n=326)
Does 12-lead resting ECG accurately detect echocardiographic left ventricular hypertrophy in Tanzanian adults with hypertension and diabetes?
ECG has low sensitivity for detecting LVH in Tanzanian adults, with gender differences in the performance of Sokolow-Lyon and Cornell product criteria.
Background: Although an electrocardiogram (ECG) is often used as the only tool to detect left ventricular hypertrophy (LVH) in many out-patient clinics in sub-Saharan Africa (SSA), its sensitivity has been reported to be low especially among black populations, and several studies have reported gender differences. These observations have however not been widely studied among SSA blacks. Aim: To study the sensitivity and specificity of the ECG in detecting echocardiographic LVH in a sample of native adult Tanzanians. Methods: Echocardiography and 12-lead resting ECGs were performed in Tanzanian adults who participated in studies to determine the prevalence and functional consequences of abnormal left ventricular geometry in out-patients with hypertension and diabetes. ECG-LVH was determined using Sokolow-Lyon (S-L) and Cornell product (C-P) criteria, and compared with echocardiographic LVH. Results: In total, 326/425 (76.7%) participants of the original cohort had both ECG and echocardiogram measurements, and were included in this analysis. Echocardiographic LVH was present in 23.7% and 26.2% of men and women, respectively, while ECG-LVH was detected by S-L in 36.3% of men and 17.3% of women, and by C-P criteria in 20% of men and in 30.4% of women. The sensitivity 95% CI and specificity 95% CI of the S-L criteria was 43.8% 26.8– 62.1% and 66.0% 55.9– 74.9% in men while it was 36% 23.3– 50.9% and 89% 82.8– 93.7% in women, respectively. For the C-P criteria, the sensitivity and specificity were 43.8% 26.8– 62.1% and 87.4% 79.0– 92.8% in men and 60% 45.2– 73.3% and 80.1% 89.7– 97.8% in women, respectively. Conclusion: The sensitivity of the ECG to detect LVH is low in this population, but better than that found in many white populations. Men and women have differences in the sensitivity of the different ECG criteria, with men performing better with S-L and women with C-P criteria. These differences should be considered when including or excluding cases with ECG-LVH in our populations. Keywords: electrocardiogram, left ventricular hypertrophy, echocardiography, sensitivity, specificity, Tanzania, sub-Saharan Africa
Pilly Chillo (Thu,) conducted a cross-sectional in Left ventricular hypertrophy (n=326). Electrocardiogram (Sokolow-Lyon and Cornell product criteria) vs. Echocardiography was evaluated on Sensitivity and specificity of ECG to detect echocardiographic LVH. ECG sensitivity for detecting echocardiographic LVH in Tanzanian adults was low, with Sokolow-Lyon performing better in men (43.8%) and Cornell product performing better in women (60%).