| Performance of electrocardiographic criteria for left ventricular hypertrophy as compared with cardiac computed tomography: from the Rule Out Myocardial Infarction Using Computer Assisted Tomography trial. | |
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MedLine Citation:
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PMID: 20498615 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Cardiac computed tomography (CT) is a state-of-the-art technology that provides an accurate noninvasive method to quantify left ventricular mass for analysis of left ventricular hypertrophy (LVH). We aimed to examine seven ECG-based LVH criteria against two CT indexation criteria for LVH: a CT-specific body surface area cutoff and the obesity-independent height criteria. METHODS: In 333 patients (mean age 53 +/- 12 years, 61% men), 64-slice contrast-enhanced CT was performed and 12-lead surface ECG within 24 h. Left ventricular mass was measured at end-diastole. Using both CT indexation criteria, the cohort was subdivided into patients with LVH and without LVH. The seven ECG criteria for LVH were the Cornell voltage index, Cornell voltage duration product, Cornell/strain index, Sokolow-Lyon index, Romhilt-Estes scores at least 4 and at least 5, and Gubner-Ungerleider. RESULTS: The ECG parameters had high specificities (85-97%) and variable low sensitivities (4-43%) when compared to either CT criteria of LVH. The three Cornell-based methods performed the best (test-positive likelihood ratio: 4.5-6.7), followed by the Sokolow-Lyon and Romhilt-Estes scores (test-positive likelihood ratio: 2.3-4.0). With the exception of the Gubner-Ungerleider criterion, the other six ECG criteria were associated with at least one of the CT-based LVH (adjusted odds ratio 2.4-9.5) and had incremental predictive value beyond that of hypertension history. CONCLUSION: Using cardiac CT as a gold standard for LVH assessment, ECG criteria for LVH have high specificities with the three Cornell-based criteria providing the best test performance for identifying patients with LVH. |
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Authors:
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Quynh A Truong; Leon M Ptaszek; Elizabeth M Charipar; Carolyn Taylor; Joao D Fontes; Matthias Kriegel; Thomas Irlbeck; Michael Toepker; Christopher L Schlett; Fabian Bamberg; Ron Blankstein; Thomas J Brady; John T Nagurney; Udo Hoffmann |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of hypertension Volume: 28 ISSN: 1473-5598 ISO Abbreviation: J. Hypertens. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-11 Completed Date: 2010-12-07 Revised Date: 2011-12-07 |
Medline Journal Info:
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Nlm Unique ID: 8306882 Medline TA: J Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 1959-67 Citation Subset: IM |
Affiliation:
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Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA. qtruong@partners.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Cohort Studies Electrocardiography* / statistics & numerical data Female Humans Hypertrophy, Left Ventricular / diagnosis*, radiography* Male Middle Aged Myocardial Infarction / diagnosis, radiography Predictive Value of Tests Prospective Studies Tomography, X-Ray Computed* / statistics & numerical data |
| Grant Support | |
ID/Acronym/Agency:
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K23 HL098370-03/HL/NHLBI NIH HHS; L30 HL093806-01/HL/NHLBI NIH HHS; L30HL093896/HL/NHLBI NIH HHS; R01 HL080053/HL/NHLBI NIH HHS; T32HL076136/HL/NHLBI NIH HHS |
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