title: Left ventricular hypertrophy detection from simple clinical measures combined with electrocardiographic criteria in a group of African ancestry.
abstract: BACKGROUND
  Whether routine clinical parameters associated with left ventricular mass (LVM) enhance the performance of electrocardiographic (ECG) criteria for LV hypertrophy (LVH) detection and hence modify overall cardiovascular risk stratification is unknown.
  
  
  METHODS
  An approach to echocardiographic LVH detection was identified from ECG criteria and clinical variables [age, body mass index (BMI), systolic blood pressure (SBP) and estimated glomerular filtration rate] associated with LVM in 621 participants of African ancestry. Performance (area under the receiver operating curve) and classification accuracy for LVH detection and the impact on cardiovascular risk stratification were determined.
  
  
  RESULTS
  Compared to Cornell criteria alone, the combined use of Cornell criteria and clinical variables increased the performance (p < 0.001) and sensitivity (p < 0.05 to p < 0.0001) for LVH detection. The use of Cornell product together with additional clinical parameters as compared to Cornell product criteria alone increased the proportion of participants with pre-, grade I or grade II hypertension risk stratified as having a high added cardiovascular risk (56.3-67.9 %, p < 0.05).
  
  
  CONCLUSIONS
  In individuals of African ancestry, a combination of Cornell product criteria and age, BMI and SBP improves classification accuracy of Cornell criteria for LVH and increases those identified as having a high added as compared to lower cardiovascular risk scores.
authors.affiliation: Cardiovascular Pathophysiology and Genomics Research Unit, Faculty of Health Sciences, School of Physiology, University of the Witwatersrand Medical School, 7 York Road Parktown, 2193, Johannesburg, South Africa.
authors.forename: Fabian
authors.initials: F
authors.lastname: Maunganidze
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Woodiwiss
authors.forename: Carlos D
authors.initials: CD
authors.lastname: Libhaber
authors.forename: Muzi J
authors.initials: MJ
authors.lastname: Maseko
authors.forename: Olebogeng H I
authors.initials: OH
authors.lastname: Majane
authors.forename: Gavin R
authors.initials: GR
authors.lastname: Norton
mesh_terms: D000328:Adult; D044383:Black People; D001795:Blood Pressure Determination / Q000379:methods; D015992:Body Mass Index; D015331:Cohort Studies; D003906:Developing Countries; D015150:Echocardiography, Doppler / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D015999:Multivariate Analysis; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013019:South Africa