title: Accuracy of European diagnostic criteria for familial hypertrophic cardiomyopathy in a genotyped population.
abstract: BACKGROUND
  Since the sensitivity of conventional diagnostic criteria for familial hypertrophic cardiomyopathy (HCM) is low, new diagnostic criteria were proposed by a European collaboration. However, their diagnostic value remains unknown. The aim of the study was to evaluate the accuracy of these new criteria, using the genetic status as the criterion of reference.
  
  
  METHODS
  We studied 109 genotyped adults (54 genetically affected, 55 unaffected) from 7 families (mutations in 3 genes). Major European echographic criteria were a maximal wall thickness >or=13 mm or >or=15 mm according to the segment involved, or the presence of SAM. Major European ECG criteria were abnormal Q waves, left ventricular hypertrophy, or marked ST-T changes. Combined major/minor European criteria were also evaluated.
  
  
  RESULTS
  Sensitivity and specificity of major European criteria (72 and 92%, respectively) were similar to those of major conventional criteria (70 and 94%) and were not improved by combined major/minor European criteria (72 and 90%). When all the minor European criteria were considered, sensitivity increased to 87% but specificity dramatically decreased to 51%. However, one of these minor ECG criteria, deep S V2, was of interest and when added to major European criteria, sensitivity increased to 76% and specificity remained good (90%).
  
  
  CONCLUSIONS
  The diagnostic value of new European criteria for HCM was evaluated for the first time. We found that it was not different from that of conventional criteria, with a good specificity but a low sensitivity. Additional criteria should be studied to improve the early identification of HCM.
authors.affiliation: Service de Cardiologie, Hôpital Pitié-Salpêtrière, Paris, France. pcharron@inforbiogen.fr
authors.forename: P
authors.initials: P
authors.lastname: Charron
authors.forename: J F
authors.initials: JF
authors.lastname: Forissier
authors.forename: M E
authors.initials: ME
authors.lastname: Amara
authors.forename: O
authors.initials: O
authors.lastname: Dubourg
authors.forename: M
authors.initials: M
authors.lastname: Desnos
authors.forename: J B
authors.initials: JB
authors.lastname: Bouhour
authors.forename: R
authors.initials: R
authors.lastname: Isnard
authors.forename: A
authors.initials: A
authors.lastname: Hagege
authors.forename: A
authors.initials: A
authors.lastname: Bénaïche
authors.forename: P
authors.initials: P
authors.lastname: Richard
authors.forename: K
authors.initials: K
authors.lastname: Schwartz
authors.forename: M
authors.initials: M
authors.lastname: Komajda
mesh_terms: D000328:Adult; D024741:Cardiomyopathy, Hypertrophic, Familial / Q000175:diagnosis* / Q000235:genetics* / Q000503:physiopathology; D003299:Cooperative Behavior; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005060:Europe; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity