Improvements in ECG accuracy for diagnosis of left ventricular hypertrophy in obesity
| العنوان: | Improvements in ECG accuracy for diagnosis of left ventricular hypertrophy in obesity |
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| المؤلفون: | Rider, OJ, Ntusi, NAB, Bull, SC, Nethonda, R, Ferreira, V, Holloway, CJ, Holdsworth, D, Mahmod, M, Rayner, JJ, Banerjee, R, Myerson, SG, Watkins, HC, Neubauer, SK |
| المصدر: | Heart |
| بيانات النشر: | BMJ Publishing Group, 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Adult, Male, Action Potentials, Reproducibility of Results, Signal Processing, Computer-Assisted, Middle Aged, Magnetic Resonance Imaging, Body Mass Index, Special Populations, Electrocardiography, Heart Conduction System, Heart Rate, Predictive Value of Tests, Humans, Female, Hypertrophy, Left Ventricular, cardiovascular diseases, Obesity, Aged, Retrospective Studies |
| الوصف: | Objectives The electrocardiogram (ECG) is the most commonly used tool to screen for left ventricular hypertrophy (LVH), and yet current diagnostic criteria are insensitive in modern increasingly overweight society. We propose a simple adjustment to improve diagnostic accuracy in different body weights and improve the sensitivity of this universally available technique. Methods The electrocardiogram (ECG) is the most commonly used tool to screen for left ventricular hypertrophy (LVH), and yet current diagnostic criteria are insensitive in modern increasingly overweight society. We propose a simple adjustment to improve diagnostic accuracy in different body weights and improve the sensitivity of this universally available technique. Results When matched for left ventricular mass, the combination of leftward anatomical axis deviation and increased BMI resulted in a reduction of the Sokolow-Lyon index, by 4mm in overweight and 8mm in obesity. After adjusting for this in the initial cohort, the sensitivity of the Sokolow-Lyon index increased (overweight; 12.8% to 30.8%, obese 3.1% to 27.2%) approaching that in normal weight (37.8%). Similar results were achieved in the validation cohort (specificity increase overweight; 8.3% to 39.1%, obese 9.4% to 25.0%) again approaching normal weight (39.0%). Importantly, specificity remained excellent (>93.1%). Conclusion Adjusting the Sokolow-Lyon index for BMI (overweight +4mm, obesity +8mm) improves the diagnostic accuracy for detecting LVH. As the ECG, worldwide, remains the most widely used screening tool for LVH, implementing these findings should translate into significant clinical benefit. |
| اللغة: | English |
| تدمد: | 1468-201X 1355-6037 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=pmid_dedup__::568877af459a0c09cadd350e65b1a385 http://europepmc.org/articles/PMC5037604 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.pmid.dedup....568877af459a0c09cadd350e65b1a385 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1468201X 13556037 |
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