Background This study evaluated factors independently associated with electrocardiographic left ventricular hypertrophy (ECG-LVH) in subjects who were normotensive on clinical measurement and had no prior history of hypertension.
Methods This cross-sectional study analyzed cases and controls in the Comprehensive Medical Examination Center of Hallym University Sacred Heart Hospital. Eligible case participants presented ECG-LVH according to the Sokolow-Lyon or Cornell criteria, were normotensive on clinical measurement, and had never received a diagnosis of hypertension. The control group comprised subjects with normal sinus rhythm who were normotensive on clinical measurement with no history of hypertension.
Results A multiple logistic regression model showed male sex, age and systolic blood pressure to be positively related to the presence of ECG-LVH. A positive relation of smoking and regular exercise; an inverse relation of pulse rate to the presence of ECG-LVH were found only in men. An inverse relation of uric acid level was found only in women. Detailed analyses of relatively healthy and young men according to whether or not to exercise regularly showed that positive relations of age and systolic blood pressure; an inverse relation of obesity to the presence of ECG-LVH were apparent in the non-regular exercise group but not in the regular exercise group. In the regular exercise group, only pulse rate showed significant (inverse) association with the presence of ECG-LVH.
Conclusion The varying risk factor profiles associated with ECG-LVH according to sex and the participation in regular exercise may help to elucidate the ECG-LVH in clinical normotensives with no prior history of hypertension.
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Prevalence, Performance and Predictors of Electrocardiographic Left Ventricular Hypertrophy in Male Black Athletes: A Retrospective Study Tochukwu F. Ilodibia, Clement O. Odigwe, Augustine N. Odili Indian Journal of Clinical Cardiology.2024; 5(1): 15. CrossRef
Background Left ventricular hypertrophy (LVH) is closely related with a high death rate, rhythmia, ischemic heart disease, stroke and sudden death. It is known that the prognosis becomes better as LVH regresses. Therefore, it is important to diagnose it correctly with ease in primary care. The authors evaluated the most standard cardio-thoracic ratio (CTR) with respect to LVH oriented towards elderly people whose body habitus changed over time as they had become older, and evaluated the factors which affect the rate of diagnosis including sensitivity and specificity. Methods: A total of 231 subjects over 60 years of age who visited a general hospital health promotion center from March 1997 to August 2003, underwent echocardiography and identified not to have heart disease were selected. LV (left vetricular) mass was measured through echocardiography. LV mass was divided by 2.7 times of height (m) by Deveruex's method, and 49.1 g/m2.7 for men and 46.7 g/m2.7 for women were set to be standards of LVH. CTR was obtained by dividing the maximum transverse diameter of the heart by maximum transverse diameter of thorax on chest PA. Results: CTR was observed on the basis of 0.45, 0.5, 0.55, and the agreement was highest of 0.5 for men and 0.45 for women. However, considering the sensitivity, the specificity, and the positive predictive value, it was thought to be most proper to be set at 0.5 was be standard for both men and women. When diagnosing LVH through chest PA, if 0.5 was set to be standard, false positive become high in women, false negative became high as height increased, and false negative became high as body mass index (BMI) increased. The smoking group showed higher false negative compared to the non- smoking group, and the false negative was higher as the level of hemoglobin increased. Conclusion: When diagnosing LVH through CTR in elderly people, it was appropriate to set 0.5 as a standard, but it is necessary to consider sex, body habitus, BMI, smoking and the level of hemoglobin. (J Korean Acad Fam Med 2007;28:690-697)
Background Left ventricular hypertrophy (LVH) has been shown to be an independent risk factor for cardiovascular morbidity and mortality. The combination of hypertension and obesity are well known to act as risk factors of left ventricular hypertrophy in a number of studies, but it is unclear whether obesity itself stimulates LVH independently. Therefore, we investigated the relationship of left ventricular mass to body size in normotensive adults. Methods: A population sample of 240 normotensive (systolic BP ＜140 mmHg and diastolic BP ＜90 mmHg) adults (139 men and 101 women) was examined by echocardiography. We excluded adults with history of hypertension, thyroid diseases, diabetes mellitus and other cardiac diseases. Left ventricular mass normalized for height2.7 was used in the analyses and left ventricular hypertrophy was defined as a value of 50 g/m2.7 men or 47 g/m2.7 in women. Results: Left ventricular mass significantly and positively correlated with body mass index. On univariate correlation analysis after adjusting for age, the body mass index was associated with LV mass/height2.7 (LVMI: Left Ventricular Mass Index) in males and body mass index, waist circumference, hip circumference and waist/hip circumference ratio were associated with LVMI in females. Left ventricular hypertrophy was more frequent in overweight (33.3%) and obese (39.4%) groups than in lean group (15.9%). Conclusion: Left ventricular mass was strongly related to obesity in normotensive adults, especially in females. Obesity may be an independent risk factor for left ventricular hypertrophy. (J Korean Acad Fam Med 2007;28:249- 255)
Background This study was designed to elucidate which factors affected left ventricular hypertrophy (LVH) on ECG in middle-aged normotensive healthy men. Methods: A total of 436 normotensive office workers who visited the health examination center of St. Mary's Hospital of Catholic University in Korea from August 1 to October 30, 2002, were divided into two groups; 138 with LVH on ECG were grouped as LVH and 298 who showed no LVH on ECG were grouped as non-LVH. Questionnaires on history of smoking, drinking and exercise were filled out, and body fat, body mass index, blood pressure and biochemical markers were measured. Related factors with LVH on ECG were statistically analyzed with Chi-square test, t-test and logistic regression. Results: The mean systolic and diastolic blood pressure and mean alcohol intake (g/day) were significantly elevated in the LVH group (P＜0.005). The non-LVH group had a tendency to show increased pulse rate (P=0.058), a higher percentage of people who did not exercise at all, and a lower percentage of people who exercised regularly (P=0.056). The smoking history, BMI and other biochemical markers showed no significant differences (P＞0.1). On logistic regression analysis, there was a significant increase in odds ratio for LVH with increase in diastolic blood pressure (adjusted OR 1.048, 95% CI 1.019∼1.077), with exercise more than 3 times a week (adjusted OR 2.317, 95% CI 1.258∼4.269) and with increased alcohol intake (adjusted OR 1.010, 95% CI 1.001∼1.019). In contrast, odds ratio for LVH decreased as the pulse rate per minute increased (adjusted OR 0.974, 95% CI 0.952∼0.997). In detailed analysis comparing those who exercised regularly more than 3 times a week with those who exercised less than 3 times a week, the increase in diastolic blood pressure was a significant factor which increased the odds ratio for LVH in both groups. A significant increase in the odds ratio by mean alcohol intake per day was shown only in a group who exercised less than 3 times a week. Conclusion: As a result of this study, in normotensive middle-aged men with LVH on ECG, patients should be monitored for regular exercise and increase in diastolic blood pressure should be regarded as a risk factor for LVH on ECG irrespective of exercise. In those who do not do exercise regularly, diastolic blood pressure as well as alcohol intake should be evaluated as risk factors for LVH. (J Korean Acad Fam Med 2007;28:92-99)
Background : The purpose of this study was to examine the sensitivity and specificity of ECG as a tool for detecting echocardiographically defined LVH in a population-based sample and to examine the impact of a variety of factors that affect the sensitivity and specificity of ECG for detection of LVH.
Methods : A total of 1,130 subjects who received a thorough medical checkup for cardiologic department voluntarily were selected. The subjects were examined using M-mode echocardiography and standard 12-lead ECG. The x2 test was used to test for differences in sensitivity and specificity of ECG for echocardiographically defined LVH. Cochran-Mantel-Haenszel statistic was used to adjust for sex, age, and obesity and to test the association between cigarette smoking, amount of alcohol, exercise, hypertension, diabetes mellitus (DM) and sensitivity and specificity of ECG.
Results : Echocardiographic LVH was detected in 434 (38.4%) and electrocardiographic features of LVH were present in 146 (12.9%). ECG for diagnosis of LVH showed sensitivity of 20.0%, specificity of 91.5%, and diagnostic accuracy of 64.1%. Sensitivity of ECG for LVH was higher in persons with obesity (P=.04) or hypertension (P=.04). Specificity of ECG for LVH was lower in persons with hypertension (P=.003).
Conclusion : ECG has a low sensitivity and a high specificity for echocardiographically defined LVH. Attention must be paid to carefully interpret ECG for diagnosis of LVH in persons with obesity or hypertension, because the rate of false positives and negatives can be increased.
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