title: Electrocardiographic criteria of left ventricular hypertrophy in patients with morbid obesity.
abstract: BACKGROUND
  Obesity is frequently accompanied by systemic hypertension complicated by left ventricular hypertrophy (LVH). Standard electrocardiography (ECG) is generally accepted screening tool for LVH in systemic hypertension. The aim was to assess currently used ECG criteria in the diagnosis of LVH in morbidly obese patients.
  
  
  METHODS
  Ninety-five patients (80 women, 15 men) with body mass index ≥ 40 kg/m(2) , prior to scheduled bariatric surgery were included into the study. All patients underwent standard ECG and transthoracic ECG for LVH assessment.
  
  
  RESULTS
  Echocardiographically LVH (>110 g/m(2) in women, and >132 g/m(2) in men) was diagnosed in 54 patients (56.8%). None of the ECG criteria showed satisfactory performance in the diagnosing echocardiographically confirmed LVH. Although, Receiving operating curves (ROC) analysis showed that only Romilht-Estes score and Cornell index × QRS complex duration were characterized by area under curve >0.6 (0.662; 0.612, respectively),currently recommended values of both tests (Romilht-Estes score and Cornell index × QRS duration 2436 mm · ms) showed very low sensitivity in morbidly obese patients (0% and 2%, respectively).
  
  
  CONCLUSIONS
  Our study showed that none of voltage-based ECG criteria are of value for LVH diagnosis in severely obese patients. Only Romhilt-Estes scale and Cornell indices could be helpful for the identification of LVH in the group of patients with morbid obesity, but their value is far from being satisfactory.
authors.affiliation: Department of Internal Medicine and Cardiology, Warsaw Medical University, Warsaw, Poland. jdomienik@tlen.pl
authors.forename: Justyna
authors.initials: J
authors.lastname: Domienik-Karłowicz
authors.forename: Barbara
authors.initials: B
authors.lastname: Lichodziejewska
authors.forename: Wojciech
authors.initials: W
authors.lastname: Lisik
authors.forename: Michał
authors.initials: M
authors.lastname: Ciurzyński
authors.forename: Piotr
authors.initials: P
authors.lastname: Bienias
authors.forename: Andrzej
authors.initials: A
authors.lastname: Chmura
authors.forename: Piotr
authors.initials: P
authors.lastname: Pruszczyk
mesh_terms: D000328:Adult; D015992:Body Mass Index; D004452:Echocardiography; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D009767:Obesity, Morbid / Q000150:complications*; D012372:ROC Curve; D012680:Sensitivity and Specificity