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Djurovic, Vladimir, Aleksandra Vulin, Milovan Petrovic, and Milica Popovic. "Correlation between electrocardiographic and echocardiographic parameters in the diagnosis of left ventricular hypertrophy in hypertensive patients." Medical review 76, no. 5-6 (2023): 156–61. http://dx.doi.org/10.2298/mpns2306156d.
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Introduction. Left ventricular hypertrophy is defined as an increase in the left ventricular mass. Electrocardiography is a widely used and cost-effective method for the initial screening of the condition, but it has limited sensitivity and specificity. The Sokolow-Lyon and Cornell criteria are still most commonly used in diagnosing the disease; their sensitivity, however, is low. On the contrary, the Romhilt-Estes scoring system incorporates atrial abnormalities and repolarization phases making this scoring system a better diagnostic tool. This study explores the correlation between electrocardiography and echocardiography in the diagnosis of left ventricular hypertrophy. Material and Methods. The study enrolled 30 patients with median age of 62, diagnosed with arterial hyperten?sion, who underwent a 12-lead electrocardiogram and transthoracic echocardiogram. The analysis included the assessment of correlation between the relevant electrocardiographic parameters and the left ventricular mass index, as well as calculation of their diagnostic capability including the area under the ROC curve. Re?sults. Positive correlation of moderate intensity has been observed between the left ventricular mass index and Sokolow-Lyon (?=0.479), Cornell index (?=0.366), and Cornell product (?=0.423). Cornell product had the highest sensitivity (0.82), while the Romhilt-Estes criteria exhibited the highest specificity (0.85). Sokolow-Lyon yielded the highest area under the curve (0.733), followed by Cornell product (0.640), Cornell voltage (0.622), and Romhilt-Estes criteria (0.570). Conclusion. The Sokolow-Lyon criterion exhibited the best balance between sensitivity and specificity, the highest and significant area under the ROC curve and the strongest correlation with the left ventricular mass index.
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Yu, Zongying, Jie Song, Li Cheng, et al. "Peguero-Lo Presti criteria for the diagnosis of left ventricular hypertrophy: A systematic review and meta-analysis." PLOS ONE 16, no. 1 (2021): e0246305. http://dx.doi.org/10.1371/journal.pone.0246305.
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Background The Peguero-Lo Presti criteria are novel electrocardiographic (ECG) diagnostic criteria for the detection of left ventricular hypertrophy (LVH) and represent the sum of the amplitude of the deepest S wave in any lead with the S wave in lead V4 (SD+SV4). The diagnostic efficacy of the Peguero-Lo Presti criteria in LVH is still debatable. We aimed to test the sensitivity and specificity of the Peguero-Lo Presti criteria and compared them with those of the Cornell voltage index to assess their overall performance in LVH diagnosis. Methods Electronic databases (e.g., Medline, Web of Knowledge, Embase, and the Cochrane Library) were searched from their inception until May 18, 2020. Trials written in English that investigated the Peguero-Lo Presti criteria for detecting LVH were included. Data were independently extracted and analyzed by two investigators. Results A total of 51 records were screened, and 6 trials comprising 13,564 patients were finally included. A bivariate analysis showed that the sensitivity of the Peguero-Lo Presti criteria (0.52, 95% confidence interval (CI) 0.46–0.58) was higher than that of the Cornell voltage index (0.29, 95% CI 0.23–0.36) and Sokolow-Lyon criteria (0.24, 95% CI 0.21–0.27); the diagnostic accuracy of the Peguero-Lo Presti criteria (0.69, 95% CI 0.65–0.73) was also higher than that of the Cornell voltage index (0.67, 95% CI 0.62–0.71) and Sokolow-Lyon criteria (0.28, 95% CI 0.25–0.32); and the specificity of the Peguero-Lo Presti criteria (0.85, 95% CI 0.79–0.90) was similar to that of the Cornell voltage index (0.92, 95% CI 0.89–0.95) and Sokolow-Lyon criteria (0.94, 95%CI 0.88–0.97). Two trials (including 12,748 patients) were discharged because they included partly healthy subjects and accounted for substantial heterogeneity. Pooled analysis of the remaining 4 trials (including 816 patients) showed that the sensitivity of the Peguero-Lo Presti criteria (0.56, 95% CI 0.51–0.61) was also higher than that of the Cornell voltage index (0.36, 95% CI 0.31–0.42) and Sokolow-Lyon criteria (0.24, 95% CI 0.18–0.31); the diagnostic accuracy of the Peguero-Lo Presti criteria (0.84, 95% CI 0.80–0.87) was also higher than that of the Cornell voltage index (0.54, 95% CI 0.50–0.58) and Sokolow-Lyon criteria (0.38, 95% CI 0.34–0.42); and the specificity of the Peguero-Lo Presti criteria (0.90, 95% CI 0.87–0.92) was similar to that of the Cornell voltage index (0.93, 95% CI 0.88–0.96) and Sokolow-Lyon criteria (0.97, 95% CI 0.90–0.99). Both the likelihood ratio and posttest probability of the Peguero-Lo Presti criteria and Cornell voltage index were moderate. Conclusion Based on this systematic review and meta-analysis, the Peguero-Lo Presti criteria-based ECG diagnostic method for LVH has high sensitivity, specificity and diagnostic accuracy and should be applied in clinical practice settings.
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Makoveeva, E. A., and L. P. Efimova. "Gender differences of voltage electrocardiographic criteria of left ventricular hypertrophy in hypertensive individuals living in the North." "Arterial’naya Gipertenziya" ("Arterial Hypertension") 18, no. 2 (2012): 148–52. http://dx.doi.org/10.18705/1607-419x-2012-18-2-148-152.
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Objective. To estimate the changes of voltage electrocardiographic criteria of the left ventricular hypertrophy in arterial hypertension in subjects of different gender. Design and methods. The study included 94 hypertensive patients (55 males, 39 females). Mean age was 51 ± 6 years. Based on gender and the presence of left ventricular hypertrophy patients were divided into four groups. Results. There were significant differences of indices of Sokolow-Lyon and Cornell in males with I and II stages of arterial hypertension (р = 0,012 and р = 0,017, respectively). The same differences were found in females with I and II stages of arterial hypertension (р = 0,037 and р = 0,001, respectively). Specificity was 92 % for both indices, and the sensitivity was 26 % for Sokolow-Lyon index, and 39 % for Cornell index. In women sensitivity was 0 and 72 % for Sokolow-Lyon and Cornell indices, respectively, and specificity was more than 90 % for both criteria. Conclusion. Gender differences should be considered when voltage electrocardiographic criteria of the left ventricular hypertrophy are assessed in hypertensive patients.
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Di Gioia, Giuseppe, Antonio Creta, Cosimo Marco Campanale, et al. "ECG is an inefficient screening-tool for left ventricular hypertrophy in normotensive African children population." PeerJ 4 (September 7, 2016): e2439. http://dx.doi.org/10.7717/peerj.2439.
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BackgroundLeft ventricular hypertrophy (LVH) is a marker of pediatric hypertension and predicts development of cardiovascular events. Electrocardiography (ECG) screening is used in pediatrics to detect LVH thanks to major accessibility, reproducibility and easy to use compared to transthoracic echocardiography (TTE), that remains the standard technique. Several diseases were previously investigated, but no data exists regarding our study population. The aim of our study was to evaluate the relationship between electrocardiographic and echocardiographic criteria of LVH in normotensive African children.MethodsWe studied 313 children (mean age 7,8 ± 3 yo), in north-Madagascar. They underwent ECG and TTE. Sokolow-Lyon index was calculated to identify ECG-LVH (>35 mm). Left ventricle mass (LVM) with TTE was calculated and indexed by height2.7(LVMI2.7) and weight (LVMIw). We report the prevalence of TTE-LVH using three methods: (1) calculating percentiles age- and sex- specific with values >95th percentile identifying LVH; (2) LVMI2.7>51 g/m2.7; (3) LVMIw>3.4 g/weight.Results40 (13%) children showed LVMI values >95th percentile, 24 children (8%) an LVMI2.7>51 g/m2.7while 19 children (6%) an LVMIw>3.4 g/kg. LVH-ECG by Sokolow-Lyon index was present in five, three and three children respectively, with poor values of sensitivity (ranging from 13 to 16%), positive predictive value (from 11 to 18%) and high values of specificity (up to 92%). The effects of anthropometrics parameters on Sokolow-Lyon were analyzed and showed poor correlation.ConclusionECG is a poor screening test for detecting LVH in children. In clinical practice, TTE remains the only tool to be used to exclude LVH.
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Marquez, Mary Grace A., and Romulo Rommel Rosita. "Diagnostic Performance of Electrocardiographic Criteria Compared With Echocardiographic Diagnosis of Left Ventricular Hypertrophy in Patients at the Outpatient Department." Philippine Journal of Cardiology 51, no. 1 (2023): 55–61. http://dx.doi.org/10.69944/pjc.19bba851da.
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INTRODUCTION: Several electrocardiographic (ECG) criteria have previously been suggested to diagnose left ventricular hypertrophy (LVH). Studies on diagnostic performance of each criterion in Asian population were limited and this study was done to determine the diagnostic performance of the six different ECG criteria, including the newly developed Peguero–Lo Presti criterion, in diagnosing LVH in Filipino patients. METHODOLOGY: A single-center retrospective cohort study was conducted. The comparison of ECG to echocardiographic diagnosis of LVH was assessed by Spearman ρ correlation. The area under the curve analysis was used to evaluate discrimination ability of ECG-LVH criteria to identify echocardiography-LVH. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the six criteria were described with 95% confidence interval, with P < 0.05 considered statistically significant. RESULTS: A total of 325 patients were included in the final analysis; 56.61% had LVH, 23.07% of which were both ECG-based and echocardiography-based LVH. The Peguero–Lo Presti criterion had the highest sensitivity (53.1%), a lower specificity (75.5%), and a lower accuracy (68.6%), compared with the other criteria. Sokolow-Lyon index had highest specificity (97.2%) and positive predictive value (75.0%). Cornell voltage had relatively better discriminative performance (area under the curve, 0.73). CONCLUSION: Having a higher sensitivity, the Peguero–Lo Presti criterion can be used as a screening tool for LVH more than the Sokolow-Lyon and Cornell voltage. Cornell voltage criterion has higher correlation with left ventricular mass index and better discriminative ability for the detection of LVH. Further studies with the possibility of combining different ECG criteria are suggested to increase the sensitivity of the ECG criteria. KEYWORDS: Cornell voltage, electrocardiographic LVH criteria, left ventricular mass index, Peguero–Lo Presti criteria, Sokolow-Lyon voltage
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Preveden, Andrej, Mirna Usorac, Mirko Todic, Mihaela Preveden, Miodrag Golubovic, and Lazar Velicki. "Electrocardiographic features of patients with hypertrophic cardiomyopathy." Medical review 75, no. 1-2 (2022): 56–61. http://dx.doi.org/10.2298/mpns2202056p.
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Introduction. Hypertrophic cardiomyopathy is a disorder of the myocardium characterized by asymmetric or symmetric left ventricular hypertrophy. It is often an inherited disorder with an autosomal dominant pattern. The aim of this study was to evaluate the electrocardiographic characteristics of patients with hypertrophic cardiomyopathy, as well as to assess the accuracy of current electrocardiographic criteria for left ventricular hypertrophy used as indicators of hypertrophic cardiomyopathy. Material and Methods. This retrospective study was conducted using hospital medical records of 42 patients with the diagnosis of hypertrophic cardiomyopathy. Detailed electrocardiography analysis, apart from all the usual parameters, included the calculation of indices used to diagnose left ventricular hypertrophy including Sokolow augmented vector left, Cornell voltage, Cornell product, and Sokolow-Lyon index. Results. Sinus rhythm was present in 95.2% of patients, while atrial fibrillation was found in 4.8%. The majority of patients presented with left axis deviation. A slight positive correlation was found between the Sokolow augmented vector left index and posterolateral wall thickness (r = 0.475; p < 0.05), and also between the Cornell voltage index and posterolateral wall thickness (r = 0.368; p < 0.05). A borderline positive correlation was found between the Cornell product index and posterolateral wall thickness (r = 0.290; p = 0.063). Interventricular septum thickness showed no significant correlation with any of the electrocardiographic indices of left ventricular hypertrophy. Conclusion. In patients with hypertrophic cardiomyopathy, the Sokolow augmented vector left and Cornell voltage indices were the best indicators of posterolateral wall hypertrophy, whereas none of the examined indices correlated well with the interventricular septum thickness.
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Courand, Pierre-Yves, Pierre Lantelme, and Philippe Gosse. "Electrocardiographic detection of left ventricular hypertrophy: Time to forget the Sokolow-Lyon index?" Archives of Cardiovascular Diseases 108, no. 5 (2015): 277–80. http://dx.doi.org/10.1016/j.acvd.2015.03.003.
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Pereirinha, A., L. Brandão, F. de Pádua, and M. G. Lopes. "QRS abnormalities in very old people: The predictive value of the Sokolow-Lyon index." Journal of Electrocardiology 23, no. 3 (1990): 281–82. http://dx.doi.org/10.1016/0022-0736(90)90190-d.
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Krämer, Johannes, Felix Kreuzer, Michael Kaestner, et al. "Impact of the Right Ventricular Sokolow–Lyon Index in Children with Idiopathic Pulmonary Arterial Hypertension." Pediatric Cardiology 39, no. 6 (2018): 1115–22. http://dx.doi.org/10.1007/s00246-018-1862-3.
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Apitz, Anett, Thenral Socrates, Thilo Burkard, Michael Mayr, and Annina S. Vischer. "Prevalence and Characterisation of Severe Left Ventricular Hypertrophy Diagnosed by Echocardiography in Hypertensive Patients." Journal of Clinical Medicine 12, no. 1 (2022): 228. http://dx.doi.org/10.3390/jcm12010228.
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Background: Arterial hypertension (AHT) is the leading preventable cause of death worldwide. Left ventricular hypertrophy (LVH) is one of the most important prognostic markers in hypertension and a predictor for mortality. The goals of this study were to examine the prevalence of LVH detected by echocardiography in patients with AHT and to describe patients with severe LVH. Methods: This is a retrospective monocentric study including patients treated at a tertiary hypertension clinic. Echocardiographic data were taken from written reports from our hospital’s echocardiography laboratories. We compared patients with severe LVH (septum thickness ≥ 15 mm) with patients with normal left ventricular (LV) geometry and with patients with concentric or eccentric hypertrophy regarding age, gender, comorbidities, medication, duration of hypertension, blood pressure (BP) and ECG changes at time of echocardiography. Results: Twenty-nine patients (7.3%) out of four hundred patients showed severe LVH and one hundred and eighty-nine (47.3%) a normal geometry. In comparison to patients with normal geometry, patients with severe LVH were more likely to be male, older, and with more uncontrolled BP, especially regarding asleep values, multi-drug antihypertensive treatment and comorbidities. In comparison to patients with concentric or eccentric hypertrophy, patients with severe LVH had a significantly higher diastolic BP in the 24 h mean, awake and asleep values. A positive Sokolow-Lyon index did not predict LVH. However, patients with severe LVH were more likely to have T-wave-inversions V4–V6 in at least one lead. Conclusions: More than half of the patients with AHT have an abnormal geometry in our study (52.5%) and 7.3% a severe LVH. Patients with severe LVH have more often an uncontrolled AHT than patients with a normal LV geometry, despite more antihypertensive treatment. The Sokolow-Lyon index seems to be insufficient to detect LVH.
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Kharel, Sushant, Arun Kadel, Anjana Acharya, et al. "Accuracy of Electrocardiography Criteria for Left Ventricular Hypertrophy in Hypertensive Patients at Shahid Gangalal National Heart Centre." Nepalese Heart Journal 21, no. 1 (2024): 43–48. http://dx.doi.org/10.3126/nhj.v21i1.65968.
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Background: Hypertension is the leading cause of cardiovascular disease and premature death worldwide. Left ventricular hypertrophy (LVH), a measure of hypertensive target organ damage in the heart is associated with increased morbidity, mortality and development of arrhythmias. This study was designed to identify the more accurate ECG criteria for identifying LVH taking LVH by echocardiography as reference. Methods: A cross sectional study was conducted at Shahid Gangalal National Heart Centre. A total of 252 patients were included. A 12-lead ECG and Echocardiography were done. Analysis done by SPSS 25. Stata-14 software was used for ROC (Receiver operating characteristics) comparison and P<0.05 considered statistically significant. Results: Sensitivity, specificity, PPV, NPV and accuracy of Sokolow-Lyon criteria in diagnosis LVH was 41.8%, 80.8%, 67.1%, 59.7% and 61.9% respectively. The results of the test parameters taking Cornell Voltage criteria to detect LVH was 65.6%, 73.1%, 69.6% 69.3% and 69.4%. Likewise, the test parameters of cornell voltage duration measurement was 57.4%, 84.6%, 77.8%, 67.9% and 71.4% respectively. Similarly results of the test parameters by Romhilt-Estes system was 36.9%, 88.5%, 75%, 59.9% and 63.5% respectively. Area under the curve (AUC) of Sokolow-Lyon index, Cornell voltage criteria, Cornell voltage duration measurement and Romhilt- Estes system was 0.613, 0.693, 0.71 and 0.627 respectively. Conclusion: In our study Cornell Voltage duration measurement criteria had a higher sensitivity and higher AUC to detect LVH. The different ECG criteria must be integrated with the clinical scenario. Isolated interpretation of LVH using a single ECG criteria has a low diagnostic value
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Thakur, KK, S. Devkota, R. Khanal, RM Gajurel, and A. Sayami. "Sensitivity of Cornell, Sokolow-Lyon and Romhilt-Estes Electrocardiographic Criteria for Left Ventricular Hypertrophy in Nepalese Population." Journal of Institute of Medicine Nepal 38, no. 1 (2016): 3–6. http://dx.doi.org/10.59779/jiomnepal.675.
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Introduction: Hypertension with hypertensive heart disease very common cardiovascular problem in Nepalese population and major cause of morbidity and mortality. Left ventricular hypertrophy (LVH) as a marker hypertension can be detected by different ECG criteria as well as echocardiography. Here we study the sensitivity of different electrocardiography (ECG) criteria in detecting left ventricular hypertrophy in patients having LVH on Echocardiography. Methods: The study was conducted at the Echocardiography department and Out Patient Departhent of Manmohan Cardithoracic Vascular & Transplatnt Center, Institute of Medicine from May 2015 to August 2015. Ninty nine patients of hypertension having LVH on echocardiography were taken. Left ventricular hypertrophy on ECG was assessed by the help of Cornell, Sokolow-Lyon and Romhilt- Estes Point Score. Results: Mean age of the study population (99 patients) was 56.65± 13.24 and majority of the patients were in age group 50-70. Male to female ratio was 2:1. Mean body mass index of the patients was 25.51±3.5; mean systolic blood pressure was 150.23 ±21.84.Only 13% of patients had normal body weight by Body Mass Index. Among 99 patients, positive Cornell criteria in ECG were noted in 32patients (32.32%), positive Sukolow criteria in ECG were noted in 43 patients (43.43%) and positive Romhilt- Estes ECG criteria were noted in 31 patients (31.31%). Combining these three criteria LVH was detected in 62 patients (62.62%). Conclusion: Sukolow-lyon ECG criteria is most sensitivity in detection of left ventricular hypertrophy among Cornell, Suklow -lyon, Romhilt-Estes score. Sensitivity for detecting LVH is significantly increased if combined all these three criteria.
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Bolshedvorskaya, O. A., K. V. Protasov, P. S. Ulybin, and V. V. Dvornichenko. "Postoperative myocardial infarction in lung cancer patients with: incidence rate, clinical features, prognostic factors." Russian Journal of Cardiology 25, no. 11 (2020): 3946. http://dx.doi.org/10.15829/29/1560-4071-2020-3946.
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Aim. To study the incidence, clinical features and predictors of postoperative myocardial infarction (MI) after lung cancer surgery.Material and methods. The retrospective analysis included 2051 patients (1373 males and 678 females, mean age, 65,5 [62-69] years), who underwent thoracotomy for non-small cell lung cancer. At the first stage, the incidence rate of postoperative MI (%) was calculated with 95% confidential interval (CI) in relation to sex, age and extent of surgery. At the second stage, the case-control study was carried out in groups with MI revealed on the first stage (n=33) and without MI (n=130), formed by individual criteria-based matching. A comparative intergroup analysis was performed and prognostic value of 60 clinical perioperative indicators was assessed by odds ratio (OR). The features associated with MI in the univariateregression model were introduced into multivariate stepwise logistic regression. Independent MI predictors was revealed.Results. The postoperative IM incidence rate amounted to 1,61 [0,67-1,76]%. MI was more frequently diagnosed in men than women (0,29%), and after pneumonectomy (3,92%) compared with less operative extent (0,37%). MI was associated with comorbidities, smoking intensity, right pneumonectomy, preoperative increase in white blood cells, neutrophils and monocytes, blood loss volume, surgery duration, postoperative heart rate, preoperative decrease in serum total protein, postoperative haemoglobin, haematocrit, red blood cells decrease, and intraoperative blood pressure (BP). By means of multivariate logistic regression, the following factors with most accurate MI prediction were established: postoperative heart rate (OR, 4,06 [95% CI 1,58-10,43]), Sokolow-Lyon index (OR, 1,54 [95% CI 1,14-2,07]), ACS-NSQIP value for cardiac complications (OR, 3,86 [95% CI 1,36-10,92]), preoperative serum total protein (OR, 0,17 [95% CI 0,040,71]) and white blood cells (CR 1,54 [95% CI 1,03-2,31]), minimal intraoperative systolic BP (OR, 0,35 [95% CI 0,15-0,83]).Conclusion. Postoperative MI incidence in lung cancer patients accounts for 1,61%. Following independent predictors for postoperative MI were established: Sokolow-Lyon index, preoperative serum total protein and leukocytes levels, ACS-NSQIP value, minimal intraoperative systolic BP and postoperative heart rate.
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Budkiewicz, Aleksandra, Michał A. Surdacki, Aleksandra Gamrat, Katarzyna Trojanowicz, Andrzej Surdacki, and Bernadeta Chyrchel. "Electrocardiographic Versus Echocardiographic Left Ventricular Hypertrophy in Severe Aortic Stenosis." Journal of Clinical Medicine 10, no. 11 (2021): 2362. http://dx.doi.org/10.3390/jcm10112362.
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Although ECG used to be a traditional method to detect left ventricular hypertrophy (LVH), its importance has decreased over the years and echocardiography has emerged as a routine technique to diagnose LVH. Intriguingly, an independent negative prognostic effect of the “electrical” LVH (i.e., by ECG voltage criteria) beyond echocardiographic LVH was demonstrated both in hypertension and aortic stenosis (AS), the most prevalent heart valve disorder. Our aim was to estimate associations of the ECG-LVH voltage criteria with echocardiographic LVH and indices of AS severity. We retrospectively manually analyzed ECG tracings of 50 patients hospitalized in our center for severe isolated aortic stenosis, including 32 subjects with echocardiographic LVH. The sensitivity of single traditional ECG-LVH criteria in detecting echocardiographic LVH was 9–34% and their respective specificity averaged 78–100%. The ability to predict echocardiographic LVH was higher for S-waves than R-waves (mean area under the receiver operating curve (AUC): 0.62–0.70 vs. 0.58–0.65). Among combinations of R- and S-waves, the discriminating ability was highest for the Cornell voltage (AUC: 0.71) compared to the Sokolow–Lyon, Romhilt and Gubner–Ungerleider voltage (AUC: 0.62–0.68). By multiple regression, peak aortic pressure gradient was positively related to the Sokolow–Lyon (β = 1.7 ± 0.5, p = 0.002) and Romhilt voltage (β = 1.3 ± 0.5, p = 0.01), but not Cornell (0.5 ± 0.3, p = 0.2) or Gubner-Ungerleider voltage (β = 0.0 ± 0.5, p > 0.9), regardless of LV mass index. In conclusion, echocardiographic LVH and stenosis severity appear to have distinct associations with traditional ECG-LVH criteria in AS. A moderate diagnostic superiority of the Cornell voltage criterion with regard to anatomic LVH might result from its unique ability to include depolarization vectors in both the frontal and horizontal plane with consequent lesser sensitivity to the confounding effect of obesity.
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Lee, Shirleatha, Patricia Cowan, Wonsuk Yoo, and Glenn Wetzel. "Determining Left Ventricular Hypertrophy in Overweight-Obese Youth Using Electrocardiogram Criteria." Journal of Nursing Measurement 21, no. 2 (2013): 178–87. http://dx.doi.org/10.1891/1061-3749.21.2.178.
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Background and Purpose: There is an escalating prevalence of obesity in youth that increases the risk for cardiovascular alterations such as left ventricular hypertrophy (LVH). The purpose of this study is to identify the most effective electrical voltage measurement for determining LVH in youth who are overweight and obese. Methods: A retrospective chart review was conducted to determine sensitivity, specificity, and the receiver operator characteristic (ROC) curve of 4 popular electrical voltage measures. Results: Our findings indicated the sensitivity and specificity for Cornell product (50.0%; 96.2%), Cornell voltage (52.9%; 98.0%), Romhilt Estes (50.0%; 100.0%), and Sokolow-Lyon index (60.0%; 86.4%) consecutively. Conclusion: The Romhilt-Estes and Cornell voltage measures displayed the highest specificity and could prove to be beneficial as a screening method to rule out LVH in overweight and obese youth.
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Loukrakpam, Bidyarani, Laishram Geetanjali, O. Puinabati Luikham, and Sanjoy K. Shylla. "Electrocardiographic changes in patients with pre-eclampsia." Annals of Medical Physiology 3, no. 1 (2019): 10–13. https://doi.org/10.23921/amp.2019v3i1.26774.
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Pre-eclampsia is a hypertensive disorder of pregnancy that is associated with elevated maternal risk for cardiovascular disease. Electrocardiographic (ECG) changes in pre-eclampsia have been documented in some studies. Electrocardiography has recently emerged as a useful tool to evaluate cardiovascular complication during and after pregnancy. The present study was therefore undertaken to find out electrocardiographic changes in pre-eclamptic women, visiting Regional Institute of Medical Sciences, Manipur. The aim of this study was to determine the electrocardiographic changes in both pre-eclampsia and age matched normotensive pregnant women. In this study, 25 pregnant women (gestational age >20 weeks) with pre-eclampsia in the range of 18 to 45 years of age were recruited and compared with the equal number of age matched normotensive pregnant women. ECG parameters of pre-eclamptic women were compared with those of normotensive pregnant women. The data were then analyzed using SPSS software. Pre-eclamptic women showed significantly longer QRS (0.10±0.02 sec vs 0.09±0.05 sec), prolonged QT (0.401±0.03 sec vs 0.365±0.003sec) and QTc (457.73±37 msec vs 416.47± 25.4 msec) than control group. The study shows that electrocardiography can be used to evaluate cardiovascular risk in pre-eclamptic women.
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Barsukov, A. V., M. P. Zobnina, and M. S. Talantseva. "Left ventricular hypertrophy and outcomes: A five-year retrospective analysis of patients with essential hypertension." "Arterial’naya Gipertenziya" ("Arterial Hypertension") 18, no. 5 (2012): 385–97. http://dx.doi.org/10.18705/1607-419x-2012-18-5-385-397.
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Left ventricular hypertrophy (LVH) is the most important element of cardiovascular continuum in patients with essential hypertension (EH). The results of a five-year retrospective analysis of EH patients cohort with initially different types of left ventricular geometry (491 subjects) are presented. It is shown that the overall mortality in patients with concentric and eccentric LVH does not differ significantly (37 and 35 %, respectively) but exceeds that in subjects with normal LV geometry (20 %). Associated and concomitant pathology determine the total and cardiovascular prognosis more in patients with concentric LVH than in subjects with eccentric LVH. The presence of ECG valid quantitative and strain diagnostic LVH criteria (Sokolow-Lyon index and Perugian university sign) determines the worst remote prognosis in patients with both concentric and eccentric LVH. The enlarged size of the left atrium is an universal marker of poor outcome in hypertensive patients regardless the type оf left ventricular geometry.
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Protasov, K. V., and O. V. Fedorishina. "Resistant isolated systolic hypertension: prevalence, hemodynamic and clinical features." "Arterial’naya Gipertenziya" ("Arterial Hypertension") 18, no. 6 (2012): 497–504. http://dx.doi.org/10.18705/1607-419x-2012-18-6-497-504.
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Objective. To investigate the prevalence, clinical features and markers of resistant isolated systolic hypertension (ISH) in elderly patients. Design and methods. 261 patients with essential arterial hypertension (AH) and mean age of 73,2 ± 7,2 were included into the study. Resistant AH was diagnosed both by the office BP and ABPM criteria. We detected and compared the ABPM parameters, myocardial, vessels and renal damage signs in the resistant ISH group with those of resistant systolic-diastolic hypertension (SDH) and controlled AH groups. Factors reliably associated with resistant ISH development were revealed by logistic regression. Results and conclusion. The resistant ISH was detected by office BP in 11,8 % and by ABPM in 12,2 % of elderly patients. The resistant SDH was diagnosed in 13,6 and 5,4 % respectively. The «white-coat» effect was found in 30,4 %. In patients with resistant ISH the systolic BP variability, Sokolow-Lyon voltage index, left ventricular ejection fraction decrease occurrence and ambulatory arterial stiffness index were greater than in the compared groups. In comparison to controlled AH the aortic pulse wave velocity was higher while ankle-brachial index was lower. We found the markers of resistant ISH to be systolic BP variability, aortic pulse wave velocity and ambulatory arterial stiffness index.
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KouameBrou Appolinaire, Yeo Teniloh Augustin, Kondo John Liliane, et al. "Influence of Bust Size and Waist Circumference on Electrocardiographic Left Ventricular Voltage Index in Blacks Africans." International Journal of Physiology 12, no. 2 (2024): 3–9. http://dx.doi.org/10.37506/1jhhb671.
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Background: Several studies have investigated on relationship between anthropometric characteristics andelectrocardiographic left ventricular mass (LVM). These studies, performed mainly in Caucasians, have mostlyfocused on influence of body mass index on left ventricular voltage indices (LVVI), and rarely on bust size and/or waist circumference.Aim: To determine influence of bust size and waist circumference on LVVI in healthy sedentary people of blackAfrican origin.Method: Experimental, prospective, cross-sectional descriptive study including 66 volunteers (20 women) aged 18to 35 years. They were received in morning on empty stomach. Bust size and waist circumference were measuredwith tape measure. Standard electrocardiogram was performed at rest. R and S wave amplitude and QRScomplex duration were measured. Sokolow-Lyon, R in aVL, Cornell and Cornell product indexes were calculated.Correlation was sought between each LVVI and anthropometric characteristics studied.Results: Bust size and waist circumference were positively correlated with LVVI. Correlation with bust size wasstatistically significant for all LVVI except for R in aVL index, while for waist circumference it was only significantwith R in aVL index.Conclusion: This study confirms relationship between anthropometric characteristics and LVVI. Therefore,interpretation of LVM anomalies from LVVI should also take into consideration morphotype of each individual.
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Chlabicz, Małgorzata, Jacek Jamiołkowski, Marlena Paniczko, et al. "ECG Indices Poorly Predict Left Ventricular Hypertrophy and Are Applicable Only in Individuals with Low Cardiovascular Risk." Journal of Clinical Medicine 9, no. 5 (2020): 1364. http://dx.doi.org/10.3390/jcm9051364.
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Background: Left ventricular hypertrophy (LVH) is an important risk factor for cardiovascular events. The electrocardiography (ECG) has poor sensitivity, but it is commonly used to detect LVH. Aim: To evaluate the diagnostic efficacy of known ECG indicators to recognize LVH in subgroups with different cardiovascular risk levels. Methods: 676 volunteers were included. Results: We found that 10.2% of the analyzed population had LVH based on echocardiography. Individuals with LVH were older, had a higher body mass index, higher systolic blood pressure, lower heart rate, higher parameters of insulin resistance, higher cardiovascular risk, and android-type obesity. Variables that remained independently associated with LVH were QRS duration, left atrial volume index, troponin T, and hemoglobin A1c. The receiver operating characteristics (ROC) curve analysis of the Sokolow–Lyon index did not show a significant predictive ability to diagnose LVH in the whole study population including all cardiovascular risk classes. The ROC curves analysis of Cornell and Lewis indices showed a modest predictive ability to diagnose LVH in the general population and in a low cardiovascular class. Conclusions: There is a need for new, simple methods to diagnose LVH in the general population in order to properly evaluate cardiovascular risk and introduce optimal medical treatment of concomitant disease.
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Zvonareva, Ekaterina B., Nina G. Toporkova, and Elizaveta N. Ivanova. "Type 2 diabetes mellitus as a risk factor in cardiovascular pathologies development." Tambov Medical Journal, no. 3 (2023): 31–40. http://dx.doi.org/10.20310/2782-5019-2023-5-3-31-40.
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We present data on the correlation between diabetes mellitus and the risk of developing cardiovascular pathologies. The study involved 60 people, 30 men and 30 women, whose average age was 50–60 years. All participants were divided into three groups. The first group included people without type 1 and type 2 diabetes, but with cardiovascular diseases. The second group included people with type 2 diabetes mellitus diagnosed 2–3 years ago and cardiovascular diseases. The third group included people with type 2 diabetes mellitus diagnosed 10–15 years ago and cardiovascular diseases. All three groups were analyzed according to the following averages: blood pressure, glycated hemoglobin, total cholesterol concentration, Sokolow–Lyon index and SCORE scale values. As a result of the study and comparison of three researched groups, it was revealed that people with diabetes mellitus diagnosed 2–3 years ago already have changes in the cardiovas-cular system and people with type 2 diabetes mellitus diagnosed 10–15 years ago have significant changes. Thus, type 2 diabetes mellitus is a serious factor contributing not only to cardiovascular diseases development, but also to their rapid progression, which, in turn, significantly increases the risk of death from cardiovascular complications.
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Thijs, Lutgarde, Eoin T. OʼBrien, and Jan A. Staessen. "Ambulatory and conventional pulse pressures and mean pressures as determinants of the Sokolow-Lyon ECG voltage index in older patients with systolic hypertension." Blood Pressure Monitoring 6, no. 4 (2001): 197–202. http://dx.doi.org/10.1097/00126097-200108000-00007.
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Geraci, Giulio, Pietro Ferrara, Francesco Pallotti, et al. "Correlations Between Novel Adiposity Indices and Electrocardiographic Evidence of Left Ventricular Hypertrophy in Individuals with Arterial Hypertension." Journal of Personalized Medicine 15, no. 6 (2025): 229. https://doi.org/10.3390/jpm15060229.
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Background/Objectives: Obesity is a key driver of cardiovascular disease (CVD), with central adiposity directly involved in adverse cardiac remodeling. Body mass index (BMI) is limited in capturing fat distribution and associated cardiovascular risk. Novel anthropometric indices, including A Body Shape Index (ABSI) and Body Roundness Index (BRI), may offer greater clinical value, but their relationship with electrocardiographic markers of left ventricular hypertrophy (LVH) remains underexplored. This study aims to assess the correlation between novel adiposity indices (ABSI and BRI) and electrocardiographic evidence of LVH, as measured by the Sokolow-Lyon Index (SLI), in individuals with arterial hypertension. Methods: 274 hypertensive patients were recruited, and BMI, ABSI, and BRI were calculated. LVH was assessed via SLI on 12-lead ECG. Participants were stratified by the SLI (≤35 mm vs. >35 mm) for statistical analyses. Results: Patients with a lower SLI showed significantly higher values of ABSI and BRI compared to those in higher SLI group, without differences in BMI. In the entire population, SLI was significantly and inversely correlated with both ABSI (r = −0.296, p < 0.001) and BRI (r = −0.238, p < 0.01), but not with BMI. Multivariate regression analysis confirmed ABSI (p = 0.013) and BRI (p = 0.038) as independent predictors of SLI, even after adjusting for age, blood pressure, renal function, and metabolic parameters. Conclusions: ABSI and BRI are inversely and independently associated with ECG-derived SLI in hypertensive individuals, suggesting that central adiposity may attenuate ECG voltages and obscure LVH detection. Incorporating novel adiposity indices into ECG interpretation may enhance diagnostic accuracy and risk stratification in obese and hypertensive populations. Longitudinal studies are needed to validate these findings and refine clinical algorithms.
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Smirnova, M. I., R. G. Oganov, M. V. Gorbunov, A. D. Deev, and G. F. Andreeva. "Masked inefficacy of arterial hypertension treatment: prevalence and predictors." Cardiovascular Therapy and Prevention 10, no. 6 (2011): 11–17. http://dx.doi.org/10.15829/1728-8800-2011-6-11-17.
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Aim. To assess the prevalence of masked inefficacy of arterial hypertension treatment (AH MTI) and its predictors in various clinical groups and for various blood pressure (BP) control strategies, in order to evaluate the true effectiveness of antihypertensive therapy (AHT). Material and methods. AHT effectiveness was assessed in two groups of the patients with Stage I-II AH (n=219 and n=39), by comparing the ratios of clinical (cl) to ambulatory (a) BP parameters. AH MTI was defined as elevated aBP and target clBP levels during AHT. The potential predictors of AH MTI included gender, age, body mass index (BMI), anamnestic data, frequency of the clinical visits to measure BP, quality of life (QoL) parameters (GWBQ questionnaire), circadian BP profile, orthostatic BP, and ECG signs of left ventricular hypertrophy (LVH). Results. AH MTI prevalence in Groups I and II was 11,0-15,7 % and 22,6-58,1 %, respectively, depending on the definition used. The groups were significantly different in terms of age, BMI, and QoL questionnaire III and VI domains. According to the regression analysis results, in Group I AH MTI was associated with QoL questionnaire II, V, and VI domains, baseline parameters of 24-hour BP monitoring, 24-hour systolic BP (SBP) variability, minimal daytime levels of mean BP, and metoprolol and atenolol therapy. In Group II, AH MTI was predicted by age, BMI, previously administered AHT, alcohol consumption, orthostatic SBP levels, Sokolow-Lyon index, Cornell voltage and Cornell product, Gubner index, and QoL questionnaire I, IV, and VI domains. Conclusion. AH MTI prevalence is associated with some baseline characteristics of the patients and the character of AHT. Due to regression to the mean, AH MTI prevalence could increase substantially when clBP parameters are measured more often.
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Mester, Balázs, Zoltán Lipták, Kristóf Attila Farkas-Sütő, et al. "Inherited Hypertrabeculation? Genetic and Clinical Insights in Blood Relatives of Genetically Affected Left Ventricular Excessive Trabeculation Patients." Life 15, no. 2 (2025): 150. https://doi.org/10.3390/life15020150.
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Genetically determined left ventricular excessive trabeculation (LVET) has a wide clinical spectrum ranging from asymptomatic subjects to severe heart failure with arrhythmias and thromboembolic events. Unlike other cardiomyopathies, the relatives of LVET patients never reach the spotlight of guidelines and clinical practice, although these family members can be often affected by these conditions. Thus, we aimed to investigate the relatives of LVET by multidimensional analysis, such as genetic testing, ECG and cardiac ultrasound (ECHO). We included 55 blood relatives from the family of 18 LVET patients (male = 27, age = 44 ± 20.8y), who underwent anamnesis registration. With Sanger sequencing, the relatives were classified into genetically positive (GEN-pos) and unaffected (GEN-neg) subgroups. In addition to regular ECG parameters, Sokolow-Lyon Index (SLI) values were calculated. 2D ECHO images were analysed with TomTec Arena, evaluating LV volumetric, functional (EF) and strain parameters. Individuals were categorized into JENNI-pos and JENNI-neg morphological subgroups according to the Jenni LVET ECHO criteria. Family history showed frequent involvement (arrhythmia 61%, stroke 56%, syncope 39%, sudden cardiac death 28%, implanted device 28%), as well as personal anamnesis (subjective symptoms 75%, arrhythmias 44%). ECG and ECHO parameters were within the normal range. In terms of genetics, 78% of families and 38% of relatives carried the index mutation. LV_SLI and QT duration were lower in the GEN-pos group; ECHO parameters were comparable in the subgroups. Morphologically, 33% of the relatives met Jenni-LVET criteria were genetically affected and showed lower LV_EF values. The frequently found genetic, morphological and clinical involvement may indicate the importance of screening and, if necessary, regular follow-up of relatives in the genetically affected LVET population.
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Brou, Appolinaire Kouame, Edwige Balayssac-Siransy, Kossiwa Djaha-Toumata, et al. "Influence de la surface corporelle sur les indices de voltage ventriculaire gauche chez des sédentaires sains." International Journal of Biological and Chemical Sciences 15, no. 6 (2022): 2272–82. http://dx.doi.org/10.4314/ijbcs.v15i6.3.
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Les Indices de Voltage Ventriculaire Gauche (IVVG) électrocardiographiques sont reconnus pour avoir une faible sensibilité dans le diagnostic des anomalies de la masse ventriculaire gauche (MVG) comparativement à l’échocardiographie, méthode de référence, dont les mesures sont indexées à la Surface Corporelle (SC). Or, ces IVVG qui estiment la MVG à l’électrocardiographie ne sont pas en pratique indexés à la SC. La non-indexation des IVVG à la SC serait-elle à l’origine de leur faible sensibilité ? L’objectif de cette étude était de déterminer l’influence de la SC sur les IVVG dans une population de sujets sédentaires sains. Une étude expérimentale, prospective incluant 117 volontaires de 18 à 35 ans a été réalisée. Ils ont été reçus le matin à jeun. La prise du poids et de la taille ont servi au calcul de la SC. Un électrocardiogramme (ECG) standard a été réalisé au repos. L’amplitude des ondes R et S et la durée du complexe QRS ont été mesurées. Les indices de Sokolow-Lyon, R en aVL, de Cornell et le produit de Cornell ont été calculés puis indexés à la SC. Aucune corrélation significative n’a été obtenue entre les IVVG étudiés et la SC. L’indexation des IVVG à la SC n’a pas modifié la différence observée entre le groupe de sujets à valeurs normales non indexées et celui à valeurs élevées non indexées. Les IVVG n’ont pas été influencés par la SC dans cette étude. Une approche incluant à la fois la mesure de la SC et celle du tour de buste pourrait aider à la recherche sur l’amélioration de l’apport diagnostique des IVVG.
 
 English title: Influence of body surface area on left ventricular voltage indices in healthy sedentary subjects
 Electrocardiographic Left Ventricular Voltage Indices (LVVI) are known to have low sensitivity in the diagnosis of left ventricular mass (LVM) abnormalities compared with echocardiography, the reference method, whose measurements are indexed to body surface area (BSA). However, these LVTI that estimate LVM on electrocardiography are not in practice indexed to BSA. Could the non-indexation of LVTI to BSA be the cause of their low sensitivity? The objective of this study was to determine the influence of BSA on LVVI in a population of healthy sedentary subjects. This was an experimental, prospective study involving 117 volunteers aged 18 to 35 years. They were received in the morning on an empty stomach. Weight and height measurements were used to calculate the BSA. A standard electrocardiogram was performed at rest. R and S wave amplitude and QRS duration were measured. Sokolow-Lyon, R in aVL, Cornell index, and Cornell product were calculated and indexed to BSA. No significant correlation was obtained between the studied LVVI and BSA. Indexation of LVVI to BSA did not alter the observed difference between the non-indexed normal and non-indexed high group. LVTI were not influenced by BSA. An approach that includes both BSA and torso circumference measurement could aid research on improving the diagnostic contribution of LVTI.
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Liang, Xufei, Yueying Wang, Xi Yin, et al. "Electrocardiographic Characteristics of Breast Cancer Patients Treated with Chemotherapy." Cardiology Research and Practice 2020 (December 9, 2020): 1–7. http://dx.doi.org/10.1155/2020/6678503.
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Introduction. Patients receiving chemotherapy for breast cancer may be at risk of developing cardiac dysfunction and electrophysiological abnormalities. The aim of this study is to evaluate alterations in electrocardiographic (ECG) parameters in breast cancer patients receiving chemotherapy. Materials and Methods. This was a prospective single-center cohort study conducted in the Fourth Hospital of Hebei Medical University, China. Participants with breast cancer referred for chemotherapy from May 1, 2019, to October 1, 2019, were invited to participate in the study. Standard 12-lead ECG and echocardiography were performed at baseline or before chemotherapy (prechemotherapy) (T0), after 1 cycle (T1), after 3 cycles (T2), and at the end of chemotherapy (T3). Results. A total of 64 patients with diagnosed breast cancer undergoing chemotherapy were included. Echocardiographic parameters showed no significant variation during the entire procedure (all P > 0.05 ). The incidence of abnormal ECG increased from 43.75% at baseline to 65.63% at the end of chemotherapy, of which only the prevalence of fragmented QRS (fQRS) was significantly increased after the drug regimen (26.56% to 53.13%). At the end of the treatment, heart rate, P-wave dispersion, corrected QT interval, T-peak to T-end, RR, SV1, RV5, Sokolow–Lyon index (SLI), and index of cardioelectrophysiological balance deteriorated markedly (all P < 0.05 ). The area under the curve for SLI and QT dispersion (QTd) derived by ECG was 0.710 and 0.606, respectively. The cutoff value with 2.12 of SLI by ECG had a sensitivity of 67.2% and specificity of 71.9% for differentiating patients after therapy from baselines. The cutoff value with 0.55 of QTd had a sensitivity of 60.9% and specificity of 60.9%. Conclusions. The current study demonstrated that ECGs can be used to detect electrophysiological abnormalities in breast cancer patients receiving chemotherapy. ECG changes can reflect subclinical cardiac dysfunction before the echocardiographic abnormalities.
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Hussain, Huma, Muniza Saeed, Hifza Noor Lodhi, Shagufta Khaliq, Afsheen Zakir, and Naila Masood Riaz. "ECG for Detection of Left Ventricular Hypertrophy in patients with Chronic Kidney Disease." Pakistan Journal of Medical and Health Sciences 16, no. 12 (2022): 117–19. http://dx.doi.org/10.53350/pjmhs20221612117.
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Background: Left ventricular hypertrophy is the most common cardiac event associated with chronic kidney disease. Aim: To detect LVH by electrocardiography in patients with CKD. Study design: Observational study. Methodology: It was an observational study with total of 62 CKD patients enrolled through convenience sampling. Their blood 3ml was drawn aseptically for estimation of serum creatinine. All enrolled subjects underwent electrocardiographic examination. Patients with low GFR (<60ml/min/1.73m2) and high serum creatinine concentration (>1.5mg/dl) were included. Data was evaluated by using SPSS vr 24. The results were presented as counts, means and standard deviation as appropriate. Results: Left ventricular hypertrophy was present in 50% of enrolled patients as depicted by ECG recording. The calculated sensitivity and specificity of ECG for LVH were 75% and 100% respectively. Almost 38.7% patients were 56-65 years of age. There were 33.9% patients in the age of 35-45 years and 27.4% was in the age of 46-55 years. The median (IQR) age was 54.50 (41.75-60) years. In our study population, median (IQR) of height was 152cm (150-156). The mean weight was 65.85 kg with standard deviation of 8.42 kg i.e., 65.85 ±8.42kg. Mean body mass index was 27.85. Practical Implication: Current project helped health providers to diagnose cardiac event at an early stage among patients of kidney fail¬ure on ECG findings thus the adverse outcomes could be prevented or delayed. Conclusion: ECG abnormalities are common in hospitalized CKD patients in local population. All hospitalized CKD patients should undergo ECG to screen for cardiovascular disease. It was thus concluded that ECG can be used as a sensitive diagnostic tool in combination with different ECG indices to detect LVH. Key words: Electrocardiography, Chronic Kidney Disease, Left Ventricular Hypertrophy and Sokolow-Lyon Voltage Index
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Nowak, Bogusława, Rafał Nowakowski, Aleksandra Gapys, et al. "In search of heart barometer—advantage of left atrial dimension over electrocardiographic indices of left ventricular hypertrophy in arterial hypertension." Exploration of Cardiology 1, no. 1 (2023): 4–14. http://dx.doi.org/10.37349/ec.2023.00002.
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Aim: Left ventricular (LV) hypertrophy (LVH) is a common and relevant complication of arterial hypertension (AH) and 12-lead electrocardiogram (ECG) is widely used for its preliminary assessment. The aim of the study was to compare the correlations of four ECG-derived criteria of LVH and left atrial (LA) anteroposterior diameter with LVH assessed by echocardiography and expressed as left ventricular mass (LVM) index (LVMI) in search of the most accurate preliminary indicator of LVH. Methods: The study included 61 subjects with AH [age (year) 69 ± 10, 17 females] and 27 without AH, (age 40 ± 9, 10 females) evaluated with 12-lead ECG and transthoracic echocardiography (TTE). As the ECG-based criteria of LVH Sokolow-Lyon index (SLI), Cornell voltage (CV), Cornell product (CP), and Romhilt-Estes point score (RES) system were evaluated. The ECG indices and LA diameter were correlated with LVMI and correlations coefficients were compared. Results: Among ECG-LVH indicators SLI showed the closest correlation with LVMI [rank correlation coefficients (rho) = 0.38, P < 0.0001], followed by CV and CP with rho = 0.33, P = 0.002 and rho = 0.32, P = 0.002, respectively, whereas RES did not correlate significantly with LVMI. The strongest correlation with LVMI was found for the LA diameter with rho = 0.73 and P < 0.0001, showing an even stronger correlation in women—rho = 0.8 (P < 0.0001) vs. rho = 0.65 (P < 0.0001) in men. In the multivariate analysis, the LA was the only independent predictor of the increased LVMI with R2 = 0.52, P < 0.0001. Conclusions: LA diameter outperformed significantly the ECG indices as far as the correlation with LVMI was concerned and emerged as the only independent predictor of mild and moderate LVH in hypertensive patients. Among the ECG criteria, the strongest correlation was shown for SLI, followed by CV and CP indices.
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Zdravkovic, M., B. Milovanovic, S. Hinic, et al. "Correlation between ECG changes and early left ventricular remodeling in preadolescent footballers." Physiology International 104, no. 1 (2017): 42–51. http://dx.doi.org/10.1556/2060.104.2017.1.2.
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The aim of this study was to assess the early electrocardiogram (ECG) changes induced by physical training in preadolescent elite footballers. This study included 94 preadolescent highly trained male footballers (FG) competing in Serbian Football League (minimum of 7 training hours/week) and 47 age-matched healthy male controls (less than 2 training hours/week) (CG). They were screened by ECG and echocardiography at a tertiary referral cardio center. Sokolow–Lyon index was used as a voltage electrocardiographic criterion for left ventricular hypertrophy diagnosis. Characteristic ECG intervals and voltage were compared and reference range was given for preadolescent footballers. Highly significant differences between FG and CG were registered in all ECG parameters: P-wave voltage (p < 0.001), S-wave (V1 or V2 lead) voltage (p < 0.001), R-wave (V5 and V6 lead) voltage (p < 0.001), ECG sum of S V1–2 + R V5–6 (p < 0.001), T-wave voltage (p < 0.001), QRS complex duration (p < 0.001), T-wave duration (p < 0.001), QTc interval duration (p < 0.001), and R/T ratio (p < 0.001). No differences were found in PQ interval duration between these two groups (p > 0.05). During 6-year follow-up period, there was no adverse cardiac event in these footballers. None of them expressed pathological ECG changes. Benign ECG changes are presented in the early stage of athlete’s heart remodeling, but they are not related to pathological ECG changes and they should be regarded as ECG pattern of LV remodeling.
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Wang, Dian, Jian-Zhong Xu, Wei Zhang, et al. "Performance of Electrocardiographic Criteria for Echocardiographically Diagnosed Left Ventricular Hypertrophy in Chinese Hypertensive Patients." American Journal of Hypertension 33, no. 9 (2020): 831–36. http://dx.doi.org/10.1093/ajh/hpaa083.
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Abstract BACKGROUND Performance of electrocardiographic (ECG) criteria for echocardiographically diagnosed left ventricular hypertrophy (LVH) in Chinese hypertensive patients is not well known. We investigated the accuracy of various ECG criteria for the diagnosis of the echocardiographic LVH according to the new cutoff values of left ventricular mass (LVM) index (&gt;115 g/m2 for men and &gt;95 g/m2 for women) in Chinese hypertensive patients. METHODS Our study included 702 consecutive hypertensive inpatients including 92 (13.1%) concentric and 121 (17.2%) eccentric LVH on standard echocardiography. Diagnostic accuracy of 7 ECG criteria was evaluated by calculating sensitivity and specificity and by using the receiver operating characteristic curves. RESULTS The ECG criteria for the detection of the echocardiographically defined LVH had a sensitivity of 15%–31.9% and specificity of 91.6%–99.2% overall, 20.7%–43.5% and 91.6%–99.2% concentric, and 7.4%–23.1% and 91.6%–99.2% eccentric. ECG diagnosis of LVH defined as the positive diagnosis of any of 4 ECG criteria including Sokolow–Lyon voltage, Cornell voltage, Cornell product, and RavL voltage had a sensitivity of 54% and specificity of 86.3% overall, 71.7% and 86.3% concentric, and 40.5% and 86.3% eccentric. After adjustment for confounding factors, various ECG criteria were significantly correlated with LVM, with standardized β coefficients from 0.20 to 0.39 (P &lt; 0.001) and the highest coefficient for the Cornell product criterion. CONCLUSIONS All ECG LVH indexes had low sensitivity and high specificity in Chinese hypertensive patients. Combination of 4 or all ECG criteria might improve sensitivity without any loss of specificity.
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Sadykova, A. R., A. R. Shamkina, and R. I. Gizyatoullova. "Cardiovascular risk and unproportional high weight of left ventrical myocardium in climacteric women." Kazan medical journal 95, no. 3 (2014): 315–22. http://dx.doi.org/10.17816/kmj1504.
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Aim. To study the distribution of cardiovascular risk factors, target organ damage, associated clinical conditions and to stratify the 10-year risk of arterial hypertension complications in menopausal females depending on presence of inappropriately high left ventricular mass. Methods. 107 females from city of Kazan aged 42-59 years entered the study, including 11 women with normal blood pressure, 16 patients with high normal blood pressure, and 80 patients with hypertension according to All-Russia scientific Society of Cardiologists classification (2010) with disease duration of 0-34 years. Mean age of patients with hypertension was 51.4±4.0 years. Patients with secondary hypertension were excluded from the study. All patients underwent a questionnaire survey, physical examination, biochemical blood test, ECG, echocardiography, and cervical extracranial vessel ultrasonography. Actual left ventricle mass was calculated according to R.B. Devereux et al. (1977) and was adjusted to the body surface area. Proper left ventricle mass was defined by G. Simone et al. (1998). Disproportion coefficient was calculated as a ratio of actual left ventricle mass to proper left ventricle mass. Left ventricle hypertrophy was diagnosed using the Sokolow-Lyon index and left ventricle mass index ≥ 110 g/m2 (Echo-signs of left ventricle hypertrophy). Results. In menopausal women, inappropriately high left ventricular mass was associated with significantly (р 0.05, Fisher exact test) higher frequency of obesity, especially its abdominal type, as well as target organ damage, including Echo-signs of left ventricle hypertrophy, very high added 10-year risk of developing arterial hypertension complications. It was also associated with significantly (р 0.05, the U-criterion) higher mean values of waist circumference, waist to hip circumference ratio, body mass index, total number of damaged target organs and 10-year risk for developing arterial hypertension complications. Conclusion. Distinguishing the patients with inappropriately high left ventricular mass among menopausal women is important for planning the measures to prevent cardiovascular events.
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Stevanovic, Angelina, Danijela Tasic, Nebojsa Tasic, et al. "Similarities and Differences in Epidemiology and Risk Factors of Cerebral and Myocardial Ischemic Disease." Serbian Journal of Experimental and Clinical Research 18, s1 (2017): 75–80. http://dx.doi.org/10.1515/sjecr-2017-0045.
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Abstract Ischemic heart disease and cerebral ischemia represent the leading causes of mortality worldwide. Both entities share risk factors, pathophisiology and etiologic aspects by means of a main common mechanism, atherosclerosis. The autors aimed to investigate differences and similarities in epidemiology and risk factors that could be found between both entities. In a retrospective sudy 403 patients were included and divided into two groups: group of 289 patients with history of myocardial infarction (AMI), and group of 114 patients with history of ischemic stroke (IS). All patients were evaluated for nonmodifiable risk faktors, which included age and sex, and modifiable, such as hypertension, dyslipidemia, diabetes, obesity, physical activity and smoking. Diff erences in some epidemiological aspects were also considered: occupation, marital status, alcohol consumption, exposure to stress. Patients with history of IS were significantly older then AMI patients (64.0 ± 9.9 vs 64.0 ± 9.9, p=0,028), with higher diastolic blood pressure (87,1 ± 10,2 vs 83,6 ± 10,4, p=0,003) and higher Sokolow-Lyon index in ECG, an also index of left ventricular hypertrophy (19,2 ± 9,1 vs 14,7 ± 6,5). Th ere were no significant differences between groups in the estimated body mass index and waist circumference. Differences between groups in stress exposure, occupation, alcohol consumption or physical activity were no significant. Patients in AMI group were more frequently male (199 (69%) vs 59 (52%), p=0,001), married (252 (87%) vs 88 (77%), p=0,037), smokers (162 (56%) vs 50 (44%), p=0,018) and with higher incidence od dyslipidemia (217 (75%) vs 73 (64%), p=0,019) compared with IS group. Incidence of arterial hypertension and diabetes was similar in both groups. Both entities share similar pathophysiological mechanisms and, consequently, main traditional risk factors. However, incidence of myocardial infarction increases with male sex, dyslipidemia, smoking and marital status, while incidense of ischemic stroke increases with age, higher diastolic blood pressure and also with ECG signs of left ventricular hypertrophy.
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Luangphiphat, Wongsakorn, Atthaphon Phaisitkriengkrai, Ratikorn Methavigul, and Komsing Methavigul. "Peguero–Lo Presti criteria modified by body surface area for the electrocardiographic diagnosis of left ventricular hypertrophy in Thai patients." Asian Biomedicine 15, no. 2 (2021): 101–7. http://dx.doi.org/10.2478/abm-2021-0012.
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Abstract Background Several electrocardiographic (ECG) criteria are used to diagnose left ventricular hypertrophy (LVH); however, they have low sensitivity. Objective To assess the sensitivity of LVH diagnosis using Peguero–Lo Presti criteria modified by body surface area (BSA). Methods This study used retrospective data from 9,438 patients who attended the Central Chest Institute of Thailand from January 2017 to December 2017 with available echocardiography, and who were categorized into those with and without LVH to determine diagnostic accuracy. We randomly selected 317 patients after excluding others based on various conditions. The left ventricular mass of the 317 patients was estimated using echocardiography. Peguero–Lo Presti criteria were modified by dividing original criteria by BSA. The accuracy of the modified criteria was compared with that of the original Peguero–Lo Presti, Sokolow–Lyon, and Cornell voltage criteria. A McNemar test was used to determine the agreement of all ECG criteria examined with LV mass index. The area under a receiver operating characteristic curve (AUC) was used to assess the performance of the criteria. Results LVH was diagnosed in 164 of the 317 patients using echocardiography. The sensitivity of modified Peguero–Lo Presti criteria was 50.6% (95% confidence interval [CI] 42.7% to 58.5%), and specificity was 88.2% (95% CI 82.0% to 92.9%), with an AUC of 0.67 (95% CI 0.61–0.73). Conclusions Peguero–Lo Presti criteria modified by dividing them by BSA can improve sensitivity with acceptable specificity for the diagnosis of LVH compared with other ECG criteria examined, at least in selected Thai patients. The modified Peguero–Lo Presti criteria have accuracy similar to that for the original criteria.
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Zada, Matthew, Queenie Lo, Siddharth J. Trivedi, et al. "Electrocardiographic Characteristics and Their Correlation with Echocardiographic Alterations in Fabry Disease." Journal of Cardiovascular Development and Disease 9, no. 1 (2022): 11. http://dx.doi.org/10.3390/jcdd9010011.
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Fabry disease (FD) is an X-linked disorder with α-galactosidase A deficiency. Males (>30 years) and females (>40 years) often present with cardiac manifestations, predominantly left ventricular hypertrophy (LVH). The aim of this study was to evaluate electrocardiographic (ECG) characteristics within FD patients to identify gender related differences, and to additionally explore the association of ECG parameters with structural and functional alterations on transthoracic echocardiography (TTE). Retrospective cross-sectional analysis of 45 FD patients with contemporaneous ECG and TTE was performed and compared to age and gender matched healthy controls. FD patients demonstrated alterations in several ECG parameters particularly in males, including prolonged P-wave duration (91 vs. 81 ms, p = 0.022), prolonged QRS duration (96 vs. 84 ms, p < 0.001), increased R-wave amplitude in lead I (8.1 vs. 5.7 mV, p = 0.047), increased Sokolow–Lyon index (25 vs. 19 mV, p = 0.002) and were more likely to meet LVH criteria (31% vs. 7%, p = 0.006). FD patients with impaired basal longitudinal strain (LS) on TTE were more likely to meet LVH criteria (41% vs. 0%, p = 0.018). Those with more advanced FD (increased LV wall thickness on TTE) were more likely to meet LVH criteria but additionally demonstrated prolonged ventricular depolarization (QRS duration 101 vs. 88 ms, p = 0.044). Therefore, alterations on ECG demonstrating delayed atrial activation, delayed ventricular depolarization and evidence of LVH were more often seen in male FD patients. Impaired basal LS, a TTE marker of early cardiac involvement, correlated with ECG abnormalities. Increased LV wall thickness on TTE, a marker of more advanced FD, was associated with more severe ECG abnormalities.
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Park, Hyo Eun, Sung-Bin Chon, Sang Hoon Na, Heesun Lee, and Su-Yeon Choi. "A Fortified Method to Screen and Detect Left Ventricular Hypertrophy in Asymptomatic Hypertensive Adults: A Korean Retrospective, Cross-Sectional Study." International Journal of Hypertension 2018 (November 25, 2018): 1–8. http://dx.doi.org/10.1155/2018/6072740.
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Purpose. Left ventricular (LV) mass is determined by the wall thickness and diameter. LV hypertrophy (LVH), the increase in LV mass, is usually screened with electrocardiography but is often insensitive. We tried to fortify the rule to detect LVH using cardiothoracic ratio (CTR) in chest X-ray and well-known risk factors besides electrocardiography. Materials and Methods. This retrospective cross-sectional study included asymptomatic hypertensive individuals aged ≥40 y who underwent voluntary checkups including echocardiography. Independent variables to explain LVH (LV mass index>115 g/m2 for men and >95 g/m2 for women calculated on echocardiography) were chosen among Sokolow-Lyon voltage amplitude (SLVA), CTR and cardiovascular risk factors by multiple logistic regression analysis. The diagnostic rule to detect LVH was made by summing up the rounded-off odds ratio of each independent variable and was validated using bootstrapping method. Results. Among the 789 cases enrolled (202 females (25.6%), mean age 59.6±8.8 y), 168 (21.3%) had LVH. The diagnostic rule summed female, age≥65 y, BMI≥25 kg/m2, SLVA≥35 mm, and CTR≥0.50 (scoring 1 per each). Its c-statistics was 0.700 (95% CI: 0.653, 0.747), significantly higher (p<0.001) than that of SLVA≥35 mm, 0.522 (95% CI: 0.472, 0.572). The sensitivity and specificity of the model were 61.9% and 72.1% for score≥2 and 30.4% and 92.9% for score≥3. The SLVA≥35 mm criteria showed sensitivity of 12.5% and specificity of 91.9%. Conclusions. The rule to sum up the number of the risk factors of female, age≥65 y, BMI≥25 kg/m2, SLVA≥35 mm, and CTR≥0.50 may be a better diagnostic tool for screening LVH, than the electrocardiography-only criteria, at the score≥2.
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Pankova, O. A., and O. M. Korzh. "The significance of catestatin and relaxin-2 in the diagnosis of myocardial remodeling in patients with essential hypertension and type 2 diabetes mellitus." Ukrainian Therapeutical Journal, no. 4 (December 23, 2023): 24–32. http://dx.doi.org/10.30978/utj2023-4-24.
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Objective — to evaluate the peculiarities of electrocardiographic (ECG) and echocardiographic (EchoCG) parameters in patients with essential hypertension (EH) in combination with type 2 diabetes mellitus (T2DM) and their relationships with plasma catestatin (CTS) and relaxin‑2 (RLN2) levels.
 Materials and methods. Examinations involved 106 patients with EH, from whom 55 subjects had concomitant T2DM, and 30 practically healthy volunteers. The mean age of the participants was (64.06±8.44) years, and women prevailed in the patients’ group (55.9%). All study participants underwent anthropometric data measurement, laboratory and instrumental investigations. The levels of biomarkers CTS and RLN2 were determined with the enzyme‑linked immunosorbent assay. Instrumental investigations included electrocardiography and transthoracic echocardiography.
 Results. CTS levels were reduced in patients with concentric (5.04±1.14 ng/mL) and eccentric left ventricular hypertrophy (LVH) (5.08±0.89 ng/mL) compared with the normal geometry (6.63±0.73 ng/mL, p <0.001). The significant correlation has been established between CTS levels and ECG parameters of LVH (Cornell voltage criterion (r=–0.222; p=0.009) and Sokolow‑Lyon index (r=–0.226; p=0.008)), and EchoCG parameters, including LV end‑diastolic dimension (EDD (r=–0.388; p <0.001), LV end‑systolic dimension (ESD (r=–0.453; p <0.001), LV end‑diastolic volume index (EDVi (r=–0.329; p <0.001), LV end‑systolic volume index ESVi (r=–0.415; p <0.001), LV ejection fraction (EF (r=0.469; p <0.001), septal sickness (SS) (r=–0.593; p <0.001), posterior wall thickness (PWS) (r=–0.647; p <0.001), relative wall thickness (RWS) (r=–0.568; p <0.001), and LV myocardial mass index (LVMi) (r=–0.576; p <0.001). Patients with RLN2 ≥ 4.69 pg/mL had higher EchoCG parameters, including LV EDD, LV ESD, LV EDVi, LV ESVi, SV, SS, PWS, RWS, LVMi (p <0.05). In addition, a significant positive relationship between CTS and RLN2 levels has been revealed (r=0.191; p=0.026), which was also confirmed in the subgroup of patients with RLN2 levels above 4.69 pg/mL (r=0.585; p <0.001).
 Conclusions. The decrease in CTS levels at LVH and established correlations with the ECG signs of LVH and EchoCG parameters allow us to consider CTS as a predictor of the development of LVH, especially in patients with EH combined with T2DM.
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Michalski, Tomasz Adam, Joanna Pszczola, Anna Lisowska, et al. "ECG in the clinical and prognostic evaluation of patients with pulmonary arterial hypertension: an underestimated value." Therapeutic Advances in Respiratory Disease 16 (January 2022): 175346662210878. http://dx.doi.org/10.1177/17534666221087846.
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Background: Pulmonary arterial hypertension (PAH) is a rare disease leading to right ventricular (RV) failure and manifests in decreasing exercise tolerance. Our study aimed to assess the usefulness of electrocardiographic parameters reflecting right heart hypertrophy as predictors of clinical status in PAH. Methods: The retrospective analysis included 26 patients, mean 49 ± 17 years of age, diagnosed with PAH, and eligible to undergo cardiopulmonary exercise test (CPET). The relations between ECG values and parameters obtained in procedures such as six-minute walk test (6-MWT), echocardiography, right heart catheterization (RHC), and CPET were analyzed. Results: P-wave amplitude in lead II correlated positively with CPET parameter of respiratory response: minute ventilation to carbon dioxide production slope (VE/VCO2 slope; r = 0.436, p = 0.029) and echocardiographic estimated RA pressure (RAP; r = 0.504, p = 0.02). RV Sokolow-Lyon index (RVSLI) positively correlated with echocardiographic parameters reflecting RV function, overload, and afterload–tricuspid regurgitation pressure gradient (TRPG; r = 0.788, p < 0.001), RV free wall thickness ( r = 0.738, p < 0.001), and mean pulmonary arterial pressure (mPAPECHO; r = 0.62, p = 0.0016), respectively, as well as VE/VCO2 slope ( r = 0.593, p = 0.001) and mPAP assessed directly in RHC (mPAPRHC; r = 0.469, p = 0.0497). R-wave in lead aVR correlated positively with TRPG ( r = 0.719, p < 0.001), mPAPECHO ( r = 0.446, p = 0.033), and several hemodynamic criteria of PAH diagnosis: positively with mPAPRHC ( r = 0.505, p = 0.033) and pulmonary vascular resistance ( r = 0.554, p = 0.026) and negatively with pulmonary capillary wedge pressure ( r = −0.646, p = 0.004). QRS duration correlated positively with estimated RAP ( r = 0.589, p = 0.004), vena cava inferior diameter ( r = 0.506, p = 0.016), and RA area ( r = 0.679, p = 0.002) and negatively with parameters of exercise capacity: peak VO2 ( r = −0.486, p = 0.012), CPET maximum load ( r = − 0.439, p = 0.025), and 6-MWT distance ( r = −0.430, p = 0.046). ROC curves to detect intermediate/high 1-year mortality risk (based on ESC criteria) indicate RVSLI (cut-off point: 1.57 mV, AUC: 0.771) and QRS duration (cut-off points: 0.09 s, AUC: 703 and 0.1 s, AUC: 0.759) as relevant predictors. Conclusion: Electrocardiography appears to be an important and underappreciated tool in PAH assessment. ECG corresponds with clinical parameters reflecting PAH severity.
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Ishikawa, Joji, Yuko Yamanaka, Shintaro Watanabe, and Kazumasa Harada. "Abstract P351: Cornell Product in Electrocardiogram is More Strongly Related to LV Regional Wall Motion Than Sokolow-Lyon Voltage." Hypertension 70, suppl_1 (2017). http://dx.doi.org/10.1161/hyp.70.suppl_1.p351.
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Backgrounds: Left ventricular hypertrophy (LVH) evaluated by Cornell product in electrocardiogram predicted future stroke events greater than LVH by Sokolow-Lyon voltage. Therefore, we evaluated whether Cornell product was related to regional myocardial wall motion greater than Sokolow-Lyon voltage. Methods: We enrolled 288 hypertensive patients who were performed echocardiography for evaluating target organ damage. Cornell product was calculated as follows; R in aVL lead + S in V3 lead (0.6 mV added in female)хQRS duration; Sokolow-Lyon voltage, R in V5 lead + S in lead V1. We evaluated left ventricular mass index (LVMI), diastolic function of septal E/e’, and [longitudinal (GLS), radial (RS) and circumferential (CS)] strain using Altida (Toshiba, Japan). Results: Mean age was 63.4±13.2 years (male 47.9 %). There were 65.2 % of patients with antihypertensive medication. Both Cornell product, and Sokolow-Lyon voltage were related to LVMI (r=0.392, p<0.001 and r=0.315, p<0.001) and E/e’ (r=0.260, p<0.001; r=0.264, p<0.001), independently in multivariate linear regression analysis (both p<0.05). On the other hand, Cornell product was more strongly related, compared to Sokolow-Lyon voltage, to GLS (beta=0.200, P=0.005; beta=0.098, P=0.161), inner per outer ratio of RS (beta=-0.163, P=0.031; beta=0.117, P=0.116), and inner per outer ratio of CS (beta=0.148, P=0.044; beta=0.078, P=0.279). Conclusions: Both Cornell product and Sokolow-Lyon voltage were independently related to LVMI and diastolic function measured by tissue Doppler image; however, Cornell product was more strongly related to left ventricular regional wall motion of global longitudinal strain and trasmurality of radial and circumferential strain, than Sokolow-Lyon voltage.
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Sanchez Contreras, C., CR Sierra Fernandez, CA Mendoza Gonzalez, G. Zavala Garcia, and M. R. Garcia Arias. "Diagnostic value of Peguero Lo Presti Electrocardiografic Index for diagnosis of Left Ventricle Hypertrophy in correlation with cardiovascular magnetic resonance." EP Europace 24, Supplement_1 (2022). http://dx.doi.org/10.1093/europace/euac053.001.
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Abstract Funding Acknowledgements Type of funding sources: None. Background The gold standard for the diagnosis of left ventricular hypertrophy is cardiac magnetic resonance (CMR). Nonetheless, electrocardiogram is the most widely used screening test due to convenience, availability and low cost. There are more than 35 electrocardiographic indices to diagnose left ventricular hypertrophy among them stand out: Cornell, Sokolow-Lyon and the Index of Peguero- Lo Presti. Methods Retrospective cohort study that included 190 cardiovascular patients from January 2015 to December 2019 in a National Cardiology Center. We described demographic and electrocardiographic indices and correlate them with CMR information. A bivariate analysis was performed with association tests as Pearson, Chi square and Fisher’s exact 2x2 test. Results Our population included predominantly males (64.6%), with median age of 52 years, ischemic heart disease (74%), diabetes mellitus 2 (74%), dyslipidemia (67.9%), valvular heart disease (62.6%) and hypertension (51.6%.). Ventricular mass average140 grams, with a mean LVEF 52%. Electrocardiographic indices: Peguero Lo-Presti (75.3%) positive for left ventricular hypertrophy, Cornell Index ( 51.6%), Sokolow index (41.1%), RaVL (27.9%) and RDI (21.1%). Quantitative analysis: Peguero Lo-Presti index average 35.1 mm, Sokolow index: 30.9 mm, Cornel index: 25 mm. The most sensitive criteria to determine left ventricular hypertrophy was Peguero Lo-Presti 59.3% (95 CI 41.4% - 55.5%), followed by Cornell 51.6% (95% CI 44.5% - 58.6%), Sokolow Lyon 41.1% (95% CI34.3% to 48.2%). Conclusion Peguero- Lo Presti criteria are more sensitive than other electrocardiographic criteria for the diagnosis of left ventricular hypertrophy
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Loukrakpam, Bidyarani, Nongmaithem Sushila Devi, Konsam Biota Devi, and Ksh Lakshmikumari. "ELECTROCARDIOGRAPHY: AS PREDICTOR FOR VENTICULAR DYSFUNCTION AMONG PRE-ECLAMPTIC WOMEN." INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, September 1, 2024, 32–33. http://dx.doi.org/10.36106/ijsr/0606843.
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Pre-eclampsia is a hypertensive disorder of pregnancy that is associated with maternal risk of cardiovascular disease. According to AHA, women with pre-eclampsia had an increased risk of left ventricular hypertrophy one month after delivery compared to pregnant women without preeclampsia. This has prompted the need of this study with an objective to increase the awareness of complication of pre-eclamptic pregnancy. In this cross sectional study, 57 pregnant women (gestational age >20 weeks) with pre-eclampsia in the range of 18 to 45 years of age were recruited and compared with the equal number of age matched normotensive pregnant women. Sokolow-Lyon index was calculated from ECG record. The data were then analysed using SPSS software. The results of the study shows that pre-eclamptic women had higher Sokolow-Lyon index than normotensive pregnancy (2.01|
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Suresh, V. Patted, C. Porwal Sanjay, S. Ambar Sameer, et al. "EVALUATION OF PEGUERO-LO PRESTI CRITERIA FOR ASSESSMENT OF LEFT VENTRICULAR HYPERTROPHY." April 3, 2018. https://doi.org/10.5281/zenodo.1218947.
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Background and objectives: The sensitivity of ECG to diagnose LVH by Peguero-Lo Presti criteria has shown higher sensitivity when compared to well established criterion like Cornell voltage and Sokolow Lyon criteria. This study was aimed to find the accuracy of Peguero Lo Presti criteria in the diagnosis of LVH in patients with hypertension. Methodology: This one cross-sectional study was conducted in the Department of Cardiology of a tertiary care centre in North Karnataka from May 2017 to October 2017. A total of 400 patients with age > 30 years having hypertension were studied. All the patients were subjected to ECG and 2D echo. Results: In this study majority (73.5%) of the patients were males and male to female ratio was 2.77:1. Most of the patients were aged between 61 to 70 years (38.50%) and the mean age was 63.79?10.36 years. Based on 2D echocardiography, LVH was diagnosed in 48% of the patients. Based on, Peguro-lo-presti, Cornell Voltage and Sokolow-Lyon criteria 30.50%, 24.50% and 21% of the patients were diagnosed to have LVH respectively. Of the 192 patients, one hundred and four (104) patients were diagnosed to have LVH based on Peguro-lo-presti criteria with strong agreement (p<0.001) between Peguro-lo-presti criteria and 2D echocardiograpgy for the diagnosis of LVH with sensitivity of 54.17%. Also using Cornell Voltage criteria 76 out of 192 were diagnosed to have LVH and the sensitivity was 39.58% and using Sokolow-Lyon criteria, 56 out of 192 were diagnosed to have LVH with sensitivity of 29.17%. The Peguero-Lo Presti ECG criteria yielded higher sensitivity (54.17%) and specificity (91.35%) in the diagnosis of LVH in patients with hypertension. Conclusion: Peguero-Lo Presti criteria has higher sensitivity and specificity in the ECG diagnosis of LVH compared to Sokolow-Lyon and Cornell voltage criteria considering LV mass index by 2D Echocardiography as reference standard.
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Ilodibia, Tochukwu F., Clement O. Odigwe, and Augustine O. Odili. "Prevalence, Performance and Predictors of Electrocardiographic Left Ventricular Hypertrophy in Male Black Athletes: A Retrospective Study." Indian Journal of Clinical Cardiology, February 3, 2024. http://dx.doi.org/10.1177/26324636231223325.
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Introduction: QRS voltages for electrocardiographic left ventricular hypertrophy (ECG-LVH) are more prominent in Black athletes than non-Black athletes. The underlying physiological relationships of ECG-LVH in BA remain enigmatic despite their greater predisposition to arterial hypertension. Objectives: To determine the frequency of eight eponymous ECG-LVH criteria in male collegiate athletes in Nigeria; To determine the diagnostic performance of the most prevalent criteria; To determine the predictors of ECG-LVH. Methods: 34 (thirty-four) athletes and 49 (forty-nine) non-athletic controls with normal electrocardiograms and echocardiograms were retrospectively recruited from an existing pre-participation screening cohort. They were all normotensive, non-obese and normoglycemic, and matched for age and body mass index (BMI). Results: The four most frequent criteria were Sokolow-Lyon index (67.6% vs. 36.7%; χ 2 = 7.7; p = .006), Romhilt’s criterion (52.9% vs. 8.2%; χ 2 = 20.6; p < .001), Peguero-Lo Presti criterion (38.2% vs. 22.4%; χ 2 = 2.43; p < .144), and Mazzoleni’s criterion (35.3% vs. 4.1%; χ 2 = 13.95; p < .001). The sensitivity, specificity and accuracy of these criteria ranged between 23.8%–57.1%, 38.5%–53.9%, and 32.4%–50.0%, respectively. Athletic activity (OR = 4.49; 95% confidence interval, CI = 1.63–12.36; p = .004) and lower BMI (OR = 0.78; 95% CI = 0.63–0.97; p = .026) were independent predictors of ECG-LVH by the Sokolow-Lyon criterion. Conclusions: Voltage ECG-LVH criteria all poorly predict the presence of echocardiographic LVH in young male Black athletes. However, the Sokolow-Lyon criterion seems to be associated with a benign cardio-metabolic profile in such athletes and appears hypothetically superior to other voltage criteria for identifying physiological cardiac remodeling in them. This hypothesis should be tested in future studies.
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Anh, Ngo Tuan, and Do Xuan Hai. "Mid-term results of surgical aortic valve replacement for aortic stenosis at 108 Military Central Hospital." Journal of 108 - Clinical Medicine and Phamarcy 16, TA (2021). http://dx.doi.org/10.52389/ydls.v16ita.1102.
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Objective: To study on medium-term results after aortic valve replacement surgery for aortic stenosis (AS) at 108 Military Central Hospital. Subject and method: 67 patients with AS received aortic artificial valves replacement. The results collected at the time of 3, 6, 12, 24, 36 and 48 months include: NYHA class, echocardiography (LVEDd, LVEDs, AVA, mean PG), Sokolow-Lyon, PPM and complications. Evaluation is based on the criteria of the Vietnam National Heart Association and the Guidelines of the ACC/AHA. Result: NYHA 1 was increased (76.1%) and NYHA 2 - 3 was 23.9% with p<0.05 in 6 months and an increasing trend at later times (p>0.05). Sokolow-Lyon index < 35mm after surgery > 90%, mid-term echocardiography AVA about 1.6cm², LVEF > 60%, mean PG < 20mmHg, LVEDd and LVEDs within normal limits. Hemorrhagic complications, stuck aortic valve (≤ 3.8%), fuite paraprosthetiques did not appear after 6 months. Conclusion: The medium-term outcome after aortic valve replacement for aortic stenosis has good clinical and subclinical improvement and the rate of medium-term complications is low.
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Yang, Yujin, Jung‐Min Ahn, Do‐Yoon Kang, et al. "Implication of Different ECG Left Ventricular Hypertrophy in Patients Undergoing Transcatheter Aortic Valve Replacement." Journal of the American Heart Association 11, no. 4 (2022). http://dx.doi.org/10.1161/jaha.121.023647.
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Background Various ECG criteria for left ventricular hypertrophy (LVH) have been proposed, but their association with clinical outcomes in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement is unknown. We investigated the prevalence of ECG LVH according to different criteria and its prognostic impact on clinical outcomes after transcatheter aortic valve replacement. Methods and Results In this prospective observational cohort, we evaluated 700 patients who underwent transcatheter aortic valve replacement between March 2010 and December 2019. Baseline preprocedural LVH was defined by 3 ECG criteria—Sokolow‐Lyon, Romhilt‐Estes, and Cornell voltage criteria. The primary outcome was major adverse cardiac or cerebrovascular event (MACCE; composite of death, myocardial infarction, stroke, or rehospitalization from cardiovascular cause); the key secondary outcome was all‐cause and cardiovascular mortality. Among 596 eligible patients, the prevalence of LVH was determined as 56.3% by Sokolow‐Lyon, 31.1% by Romhilt‐Estes, and 48.1% by Cornell criteria. Regardless of the criteria, patients with ECG LVH had more severe aortic stenosis hemodynamics and higher left ventricular mass index. After multivariate adjustment, the presence of LVH by the Cornell criteria was significantly associated with lower risks of MACCE (adjusted hazard ratio [HR], 0.68; 95% CI, 0.51–0.91; P =0.009), all‐cause mortality (adjusted HR, 0.55; 95% CI, 0.34–0.90 [ P =0.017]), and cardiovascular mortality (adjusted HR, 0.40; 95% CI, 0.20–0.79 [ P =0.008]). However, this association was absent with the Sokolow‐Lyon and Romhilt‐Estes criteria. Conclusions ECG LVH by Cornell criteria only was significantly associated with lower risks of MACCE and all‐cause or cardiovascular mortality. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03298178.
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Bazrafshan, Mehdi, Soroush Nematollahi, Maliheh Kamali, et al. "Bariatric surgery mitigated electrocardiographic abnormalities in patients with morbid obesity." Scientific Reports 14, no. 1 (2024). http://dx.doi.org/10.1038/s41598-024-57155-2.
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AbstractObesity can lead to cardiovascular dysfunctions and cause electrocardiographic disruptions. Bariatric surgery plays a significant role in weight loss. To assess its benefits, this study investigated electrocardiographic changes before and after bariatric surgery. The present article describes a retrospective cohort study with a 6-month follow-up period. Electrocardiograms were interpreted and compared before and six months after surgery. The relationships between weight loss, type of surgery, and electrocardiographic alterations were analyzed. A total of 200 patients participated in the study, with 34 (17%) men and 166 (83%) women. The mean age of the participants was 44.6 ± 8.6, and their mean body mass index was 43.8 ± 5.5 kg/m2. The mean of QTc decreased after the surgery, while the Sokolow-Lyon scores increased. The statistical analysis showed that QTc dispersion (> 40) (P < 0.001), right ventricular hypertrophy (P < 0.001), abnormal R wave progression (P < 0.001), QTc (P < 0.001) and Sokolow-Lyon criteria (P < 0.001) significantly changed postoperatively. In conclusion, bariatric surgery can reduce QTc, correct poor R wave progression, and resolve right ventricular hypertrophy (RVH) in patients with morbid obesity.
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Chlabicz, M., J. Jamiolkowski, M. Dubatowka, et al. "Time to change the electrocardiography (ECG) indices of left ventricular hypertrophy: the Bialystok PLUS and SHIP-TREND population-based studies." European Journal of Preventive Cardiology 32, Supplement_1 (2025). https://doi.org/10.1093/eurjpc/zwaf236.186.
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Abstract Background Left ventricular hypertrophy (LVH) represents a significant risk factor for cardiovascular disease (CVD). Electrocardiography (ECG) is a commonly used diagnostic tool for LVH, however, its accuracy and sensitivity are limited. Purpose The objective of this study was to evaluate the diagnostic efficacy of ECG indices in the diagnosis of LVH in the Polish and German population-based studies. Methods The Białystok Plus study (Poland) was conducted in 2017-2024. 2603 volunteers randomly chosen from the local population aged between 20 to 79 were examined. The SHIP-TREND study (Germany) was performed between 2008 and 2012. Data were obtained from 4420 volunteers randomly chosen from the population aged between 20 to 79. Exclusion criteria were incomplete data, QRS complex duration ≥ 120 ms, fascicular blocks, bundle branch blocks, paced rhythm. ECG was performed with LVH defined as &gt;35 mm for men and women using the Sokolow–Lyon index (SV1 + RV5 or V6), as &gt;28mm for men, &gt;20mm for women using Cornell index (RaVL+SV3), 17mm for both sexes using Lewis index [(RI + SIII) – (RIII + SI)]. In echocardiography (ECHO), the left ventricular mass (LVM) was calculated using the Devereux Formula. The left ventricular mass index (LVMI) was calculated by the formula LVM/BSA. The LVH was defined as LVMI ≥115 g/m2 for man and ≥95 g/m2 for women. Results 1871 individuals from the Białystok Plus study and 2708 individuals from the SHIP-TREND study were included in the study. The mean age of the Białystok Plus study population was 48.5 ± 15.0 years, while in the SHIP-TREND population it was 48.8 ± 14.3 years. The male population constituted 44.0% and 43.3% of the Białystok Plus and SHIP-TREND populations, respectively. The prevalence of LVH on ECG using the Sokolow-Lyon index was 4.2% and 0.2% in the Polish population and German population, respectively. The prevalence of LVH on ECG using the Cornell index in the Polish population was 1.4%, while in the German population it was 4.0%. The prevalence of LVH on ECG using the Lewis index in the Polish population was 2.4%, while in the German population it reached 4.7%. The percentage of individuals with LVH according to ECHO in the Białystok Plus population was 8.9%, while in the SHIP-TREND population it reached 28.8%. The receiver operating characteristics (ROC) curve analysis of the Sokolow–Lyon index did not show a predictive ability to diagnose LVH in the populations under examination. The AUC values were not significantly higher than 0.5. Sensitivity of the generally accepted cut-off was alarmingly poor for Sokolov-Lyon and Lewis criteria, specificity, however, was good (Table 1 and Figure 1). Conclusions A review of the ECG guidelines is recommended, with emphasis of the limitations of these ECG parameters. Novel clinical and ECG markers of LVH should be investigated to improve early and accurate identification of individuals at risk.
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Sager, Patrizia, Andreas Rusch, Lukas Weber, et al. "ECG left ventricular hypertrophy in aortic stenosis: Relationship with cardiac structure, invasive hemodynamics, and long‐term mortality." Clinical Cardiology, September 23, 2023. http://dx.doi.org/10.1002/clc.24155.
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AbstractBackgroundIn aortic stenosis (AS), left ventricular hypertrophy (LVH) is the response to pressure overload and represents the substrate for a maladaptive cascade, the so‐called AS‐related cardiac damage. We hypothesized that in AS patients electrocardiogram (ECG) LVH not only predicts echocardiography LVH but also other noninvasive and invasive markers of cardiac damage and prognosis after aortic valve replacement (AVR).MethodsIn 279 patients with severe AS undergoing ECG, echocardiography, and cardiac catheterization before AVR, the Sokolow‐Lyon index, the Cornell product, the Romhilt‐Estes score, and the Peguero‐Lo Presti score were assessed.ResultsThe mean left ventricular mass index was 109 ± 34 g/m2, and 131 (47%) patients had echocardiography LVH. The areas under the receiver operator characteristics curve (AUC) for the Sokolow‐Lyon index, the Cornell product, the Romhilt‐Estes score, and the Peguero‐Lo Presti score for the prediction of echocardiography LVH were 0.59, 0.70, 0.63, and 0.65. The Peguero‐Lo Presti score had the numerically greatest AUC for the prediction of left ventricular end‐diastolic pressure >15 mmHg, mean pulmonary artery wedge pressure >15 mmHg, pulmonary vascular resistance >3 Wood units, mean right atrial pressure >14 mmHg, and stroke volume index <31 mL/m2. After a median follow‐up of 1365 (interquartile range: 931–1851) days after AVR only the Peguero‐Lo Presti score was significantly associated with all‐cause mortality [hazard ratio: 1.24 (95% confidence interval: 1.01–1.54); per 1 mV increase; p = .045].ConclusionsAmong severe AS patients, the Peguero‐Lo Presti score is associated with abnormalities in cardiac structure including LVH, invasive measures of cardiac damage, and long‐term mortality after AVR.
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Nguyen Van, Tri, Bao Hoang Bui, and Minh Huynh Van. "STUDY ON CARDIOVASCULAR RISKS AND SERUM LEVELS OF NT-PROBNP IN&NBSP; PATIENTS WITH PREECLAMPSIA." Journal of Medicine and Pharmacy, February 2021, 97–104. http://dx.doi.org/10.34071/jmp.2021.1.13.
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Survey serum levels of NT-proBNP and cardiovascular risks in patients with preeclampsia. Methods: A descriptive cross-sectional study. A survey of 52 women with preeclampsia in the Department of Gynecology and Obstetrics - Hue Central Hospital, from August 2019 to September 2020. Results: In preeclampsia patients, the rate of grade 3 hypertension was 46.1%, of grade 2 hypertension was 32.7%, of grade 1 hypertension was 21.2%. The average Sokolow-Lyon index in preeclampsia group with and without severe features was respectively 22.25 ± 7.38mm; 20.16 ± 5.54mm, the average Sokolow-Lyon index were not significantly higher in severe features preeclampsia group compared with without severe features preeclampsia group. The average LVMI in patients with and without severe features preeclampsia was respectively 120.68 ± 16.47g/m2; 92.27 ± 14.56g/m2 and the average EF in patients with and without severe features preeclampsia was respectively 56.21 ± 7.12%; 65.11 ± 3.45%. The average LVMI and the average EF were significantly higher in severe features preclampsia group compared with without severe features preclampsia group (p < 0.05). In additon, the average serum levels of NT-proBNP in patients with preeclampsia were 598.22 ± 234.35pg/ml. Serum NT-proBNP levels were significantly higher in the severe features preeclampsia groups than in the without severe features group (p < 0.05). Conclusion: The NT-proBNP level were statiscally significantly increased in the patients with preeclampsia. Preeclampsia patients are at increased risks of cardivacular diseases later in life. The serum NT-proBNP level appears to be useful marker to evaluate long-term cardivascular risks.
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Braunisch, Matthias C., Peter Gundel, Stanislas Werfel, et al. "Electrocardiographic parameters of left ventricular hypertrophy and prediction of mortality in hemodialysis patients." Journal of Nephrology, May 20, 2021. http://dx.doi.org/10.1007/s40620-021-01068-0.
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Abstract Background In hemodialysis patients, left ventricular hypertrophy (LVH) contributes to high cardiovascular mortality. We examined cardiovascular mortality prediction by the recently proposed Peguero-Lo Presti voltage since it identifies more patients with electrocardiographic (ECG) LVH than Cornell or Sokolow-Lyon voltages. Methods A total of 308 patients on hemodialysis underwent 24 h ECG recordings. LVH parameters were measured before and after dialysis. The primary endpoint of cardiovascular mortality was recorded during a median 3-year follow up. Risk prediction was assessed by Cox regression, both unadjusted and adjusted for the Charlson Comorbidity Index and the Cardiovascular Mortality Risk Score. Results The Peguero-Lo Presti voltage identified with 21% the most patients with positive LVH criteria. All voltages significantly increased during dialysis. Factors such as ultrafiltration rate, Kt/V, body mass index, sex, and phosphate were the most relevant for these changes. During follow-up, 26 cardiovascular deaths occurred. Post-dialysis Peguero-Lo Presti cut-off as well as the Peguero-Lo Presti and Cornell voltages were independently associated with cardiovascular mortality in unadjusted and adjusted analysis. The Sokolow-Lyon voltage was not significantly associated with mortality. An optimal cut-off for the prediction of cardiovascular mortality was estimated at 1.38 mV for the Peguero-Lo Presti. Conclusions The post-dialysis Peguero-Lo Presti cut-off as well as the Peguero-Lo Presti and Cornell voltages allowed independent risk prediction of cardiovascular mortality in hemodialysis patients. Measuring the ECG LVH parameters after dialysis might allow a standardized interpretation as dialysis-specific factors influence the voltages. Graphical abstract