Determination of Sensitivity and Specificity of Electrocardiography for Left Ventricular Hypertrophy in a Large, Diverse Patient Population.


Journal

The American journal of medicine
ISSN: 1555-7162
Titre abrégé: Am J Med
Pays: United States
ID NLM: 0267200

Informations de publication

Date de publication:
09 2020
Historique:
received: 13 01 2020
revised: 21 01 2020
accepted: 21 01 2020
pubmed: 21 3 2020
medline: 24 11 2020
entrez: 21 3 2020
Statut: ppublish

Résumé

Electrocardiography (ECG) is poorly sensitive, but highly specific for the diagnosis of left ventricular hypertrophy. However, previous studies documenting this were small and lacked patient diversity. Furthermore, little is known about the impact of patient characteristics on the sensitivity and specificity of ECG for left ventricular hypertrophy. To address this issue, the present study was conducted to ascertain the sensitivity and specificity of ECG for left ventricular hypertrophy in a large, diverse patient population. We performed a retrospective cohort study using ECG and echocardiography (ECHO) data from a large metropolitan health system. All patients had one ECG and ECHO on file, obtained within 1 week of each other. Sensitivity and specificity of ECG for left ventricular hypertrophy were determined by comparing results from the MUSE® 12-SL (GE Healthcare, Chicago, IL) computer-generated algorithm for ECG to ECHO left ventricular mass index. Subgroup analyses of individual patient characteristics were performed with corresponding chi-squared analyses to determine significance. A total of 13,960 subjects were included in the study. The typical subject was 60 years of age or older, female, overweight, and hypertensive, and demonstrated low socioeconomic status. The sensitivity and specificity of ECG for left ventricular hypertrophy in the overall cohort were 30.7% and 84.4%, respectively, with multiple patient characteristics influencing these results. This is the first study to confirm the sensitivity and specificity of ECG for left ventricular hypertrophy in a large, diverse patient population with significant minority representation. Furthermore, although these statistical measures are influenced by patient characteristics, such differences are likely not clinically significant.

Sections du résumé

BACKGROUND
Electrocardiography (ECG) is poorly sensitive, but highly specific for the diagnosis of left ventricular hypertrophy. However, previous studies documenting this were small and lacked patient diversity. Furthermore, little is known about the impact of patient characteristics on the sensitivity and specificity of ECG for left ventricular hypertrophy. To address this issue, the present study was conducted to ascertain the sensitivity and specificity of ECG for left ventricular hypertrophy in a large, diverse patient population.
METHODS
We performed a retrospective cohort study using ECG and echocardiography (ECHO) data from a large metropolitan health system. All patients had one ECG and ECHO on file, obtained within 1 week of each other. Sensitivity and specificity of ECG for left ventricular hypertrophy were determined by comparing results from the MUSE® 12-SL (GE Healthcare, Chicago, IL) computer-generated algorithm for ECG to ECHO left ventricular mass index. Subgroup analyses of individual patient characteristics were performed with corresponding chi-squared analyses to determine significance.
RESULTS
A total of 13,960 subjects were included in the study. The typical subject was 60 years of age or older, female, overweight, and hypertensive, and demonstrated low socioeconomic status. The sensitivity and specificity of ECG for left ventricular hypertrophy in the overall cohort were 30.7% and 84.4%, respectively, with multiple patient characteristics influencing these results.
CONCLUSIONS
This is the first study to confirm the sensitivity and specificity of ECG for left ventricular hypertrophy in a large, diverse patient population with significant minority representation. Furthermore, although these statistical measures are influenced by patient characteristics, such differences are likely not clinically significant.

Identifiants

pubmed: 32194027
pii: S0002-9343(20)30202-3
doi: 10.1016/j.amjmed.2020.01.042
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e495-e500

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Maxwell Bressman (M)

Montefiore Medical Center, Department of Medicine, Division of Cardiology, Bronx, NY. Electronic address: mbressma@montefiore.org.

Alon Y Mazori (AY)

Albert Einstein College of Medicine, Bronx, NY.

Eric Shulman (E)

Montefiore Medical Center, Department of Medicine, Division of Cardiology, Bronx, NY.

Jay J Chudow (JJ)

Montefiore Medical Center, Department of Medicine, Division of Cardiology, Bronx, NY.

Ythan Goldberg (Y)

Montefiore Medical Center, Department of Medicine, Division of Cardiology, Bronx, NY.

John D Fisher (JD)

Montefiore Medical Center, Department of Medicine, Division of Cardiology, Bronx, NY.

Kevin J Ferrick (KJ)

Montefiore Medical Center, Department of Medicine, Division of Cardiology, Bronx, NY.

Mario Garcia (M)

Montefiore Medical Center, Department of Medicine, Division of Cardiology, Bronx, NY.

Luigi Di Biase (L)

Montefiore Medical Center, Department of Medicine, Division of Cardiology, Bronx, NY.

Andrew Krumerman (A)

Montefiore Medical Center, Department of Medicine, Division of Cardiology, Bronx, NY.

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Classifications MeSH