title: Left ventricular hypertrophy by electrocardiography and echocardiography in the African American Study of Kidney Disease Cohort Study.
abstract: Although electrocardiographic criteria for diagnosing left ventricular hypertrophy have a low sensitivity in the general population, their test characteristics have not been evaluated in the high-prevalence group of American Americans with chronic kidney disease. The purpose of the current study was to evaluate these test characteristics among African Americans (n = 645) with hypertensive kidney disease as part of the African-American Study of Kidney Disease and Hypertension cohort. Electrocardiograms were read by 2 cardiologists at an independent core laboratory using the 2 Sokolow-Lyon criteria and the Cornell criteria. Left ventricular hypertrophy on echocardiography was defined as left ventricular mass index greater than 49.2 and greater than 46.7 g/m(2.7) in men and women, respectively. Sixty-nine percent of the population had left ventricular hypertrophy on echo, whereas 34% had left ventricular hypertrophy by any of the electrocardiographic criteria. Sensitivity by individual electrocardiographic criteria was 16.5% by Sokolow-Lyon-1, 19.3% by Sokolow-Lyon-2, and 24.7% by Cornell criteria, with specificity ranging from 89% to 92%. When using any of the 3 criteria, sensitivity increased to 40.4% with a decrease in specificity to 78.0%. Consistent with findings in a general population, left ventricular hypertrophy by electrocardiography had low sensitivity and high specificity in this cohort of African Americans with hypertensive kidney disease.
authors.affiliation: Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Esquitin
authors.forename: Louai
authors.initials: L
authors.lastname: Razzouk
authors.forename: Gail E
authors.initials: GE
authors.lastname: Peterson
authors.forename: Jackson T
authors.initials: JT
authors.lastname: Wright
authors.forename: Robert A
authors.initials: RA
authors.lastname: Phillips
authors.forename: Tine L
authors.initials: TL
authors.lastname: De Backer
authors.forename: David A
authors.initials: DA
authors.lastname: Baran
authors.forename: Cynthia
authors.initials: C
authors.lastname: Kendrick
authors.forename: Tom
authors.initials: T
authors.lastname: Greene
authors.forename: James
authors.initials: J
authors.lastname: Reiffel
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: Michael E
authors.initials: ME
authors.lastname: Farkouh
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D001741:Black or African American; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D018450:Disease Progression; D004359:Drug Therapy, Combination; D004452:Echocardiography / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006977:Hypertension, Renal / Q000150:complications* / Q000188:drug therapy / Q000208:ethnology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000208:ethnology / Q000209:etiology; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D014481:United States / Q000453:epidemiology
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers