Abiodun Olugbenga O, Anya Tina, Adekanmbi Victor T
Internal Medicine/Cardiology, Federal Medical Centre, Abuja, NGA.
Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, USA.
Cureus. 2024 May 12;16(5):e60170. doi: 10.7759/cureus.60170. eCollection 2024 May.
Introduction To enhance the diagnosis of anatomic left ventricular hypertrophy (LVH) using electrocardiography (ECG), we aimed to identify common ECG amplitude and non-amplitude abnormalities in Nigerian patients with hypertensive echocardiographic LVH. Method The study included 1,765 patients with essential hypertension aged 18 years and older from the Federal Medical Centre Abuja Hypertension Registry (FMCAHR). Participants underwent echocardiography and ECG following the American College of Cardiology and the American Society of Echocardiography guidelines. Results The prevalence of overall ECG LVH amplitude criteria (43.8%) and individual criteria of Cornell voltage (27.1%), Sokolow-Lyon voltage (23.2%), and Gubner-Ungerleider (13.9%) were higher than non-amplitude ECG abnormalities among patients with echocardiographic LVH. The sensitivity and specificity of LVH criteria were 43.8% and 79.5% for overall ECG LVH, 23.2% and 87.2% for Sokolow-Lyon voltage, 27.1% and 93.3% for Cornell voltage, and 13.9% and 95.4% for Gubner-Ungerleider criteria, respectively. After multivariable adjustment, non-amplitude ECG changes, including prolonged corrected QT (QTc) (odds ratio (OR): 1.68, 95% confidence interval (CI): 1.06-2.66), left ventricular (LV) strain pattern (OR: 1.83, CI: 1.23-2.72), left axis deviation (OR: 1.56, CI: 1.09-2.24), poor R wave progression (OR: 2.36, CI: 1.40-3.97), premature ventricular contractions (OR: 1.80, CI: 1.10-2.91), premature atrial contractions (OR: 2.06, CI: 1.10-3.87), atrial fibrillation (OR: 2.40, CI: 1.20-4.82), and left atrial abnormality (OR: 8.43, CI: 2.95-24.05), were associated with echocardiographic LVH (p < 0.05). Conclusion In our cohort of hypertensive patients, ECG LVH amplitude criteria were the most frequently observed abnormalities associated with echocardiographic LVH. Our findings suggest that despite the low sensitivity, ECG LVH amplitude criteria may remain valuable in diagnosing echocardiographic LVH.
引言 为了通过心电图（ECG）增强对解剖学左心室肥厚（LVH）的诊断，我们旨在确定尼日利亚高血压超声心动图LVH患者常见的心电图幅度和非幅度异常。方法 该研究纳入了来自阿布贾联邦医疗中心高血压登记处（FMCAHR）的1765例18岁及以上的原发性高血压患者。参与者按照美国心脏病学会和美国超声心动图学会的指南接受了超声心动图和心电图检查。结果 在超声心动图LVH患者中，总体心电图LVH幅度标准（43.8%）以及康奈尔电压（27.1%）、索科洛夫 - 里昂电压（23.2%）和古布纳 - 昂格尔莱德（13.9%）的个体标准的患病率高于非幅度心电图异常。LVH标准的敏感性和特异性分别为：总体心电图LVH为43.8%和79.5%，索科洛夫 - 里昂电压为23.2%和87.2%，康奈尔电压为27.1%和93.3%，古布纳 - 昂格尔莱德标准为13.9%和95.4%。多变量调整后，非幅度心电图变化，包括校正QT间期延长（QTc）（比值比（OR）：1.68，95%置信区间（CI）：1.06 - 2.66）、左心室（LV）应变模式（OR：1.83，CI：1.23 - 2.72）、左轴偏移（OR：1.56，CI：1.09 - 2.24）、R波进展不良（OR：2.36，CI：1.40 - 3.97）、室性早搏（OR：1.80，CI：1.10 - 2.91）、房性早搏（OR：2.06，CI：1.10 - 3.87）、心房颤动（OR：2.40，CI：1.20 - 4.82）和左心房异常（OR：8.43，CI：2.95 - 24.05）与超声心动图LVH相关（p < 0.05）。结论 在我们的高血压患者队列中，心电图LVH幅度标准是与超声心动图LVH相关的最常观察到的异常。我们的研究结果表明，尽管敏感性较低，但心电图LVH幅度标准在诊断超声心动图LVH方面可能仍然有价值。
