Standard electrocardiographic criteria for left ventricular hypertrophy in Nigerian hypertensives.
OBJECTIVE
Left ventricular hypertrophy (LVH) is a major risk factor for cardiovascular morbidity and mortality. Various electrocardiographic criteria for LVH have differing sensitivities and specificities. Most of the available electrocardiographic criteria for LVH have not been evaluated in the African populace.


METHODS
Electrocardiograms (ECGs) and echocardiograms were obtained from 100 hypertensive subjects and 60 controls. Electrocardiogram (ECG) LVH was determined by the Sokolow-Lyon, Sokolow-Lyon-Rappaport, Cornell voltage, Romhilt-Estes point score, and the Perugia score criteria. Echocardiographic LVH was defined by LV mass indexed for height at 97.5 percentile of the controls (126 g/m and 130 g/m in females and males respectively).


RESULTS
The prevalence of echocardiographic LVH indexed for height was 34% and 1.67% in the hypertensive patients and controls respectively. The prevalence of ECG LVH obtained in the hypertensive patients with the various ECG criteria were 56% for Sokolow-Lyon-Rappaport voltage, 48% for Sokolow-Lyon voltage, 41% for Perugia score, 22% for Cornell sex specific voltage, and 18% for Romhilt-Estes score. Sokolow-Lyon-Rappaport voltage criteria had the best sensitivity (80%) and area under the receiver operating characteristic (ROC) curve while the Romhilt-Estes score had the best specificity (93%).


CONCLUSIONS
Sokolow-Lyon and Sokolow-Lyon-Rappaport voltage criteria combine the best sensitivity and specificity values and would seem better suited for the diagnosis of ECG LVH in Nigerians.
Dada
Adekola
A
Department of Medicine, University College Hospital, University of Ibadan, Nigeria.
Adebiyi
Adewole A
AA
Aje
Akinyemi
A
Oladapo
Olulola O
OO
Falase
Ayodele O
AO
D000328:Adult; D000368:Aged; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D012680:Sensitivity and Specificity