The effect of obesity on electrocardiographic detection of hypertensive left ventricular hypertrophy: recalibration against cardiac magnetic resonance.

Abstract:

:Electrocardiograph (ECG) criteria for left ventricular hypertrophy (LVH) are a widely used clinical tool. We recalibrated six ECG criteria for LVH against gold-standard cardiac magnetic resonance (CMR) and assessed the impact of obesity. One hundred and fifty consecutive tertiary hypertension clinic referrals for CMR (1.5 T) were reviewed. Patients with cardiac pathology potentially confounding hypertensive LVH were excluded (n=22). The final sample size was 128 (age: 51.0±15.2 years, 48% male). LVH was defined by CMR. From a 12-lead ECG, Sokolow-Lyon voltage and product, Cornell voltage and product, Gubner-Ungerleidger voltage and Romhilt-Estes score were evaluated, blinded to the CMR. ECG diagnostic performance was calculated. LVH by CMR was present in 37% and obesity in 51%. Obesity significantly reduced ECG sensitivity, because of significant attenuation in mean ECG values for Cornell voltage (22.2±5.7 vs 26.4±9.4 mm, P<0.05), Cornell product (2540±942 vs 3023±1185 mm • ms, P<0.05) and for Gubner-Ungerleider voltage (18.2±7.1 vs 23.3±1.2 mm, P<0.05). Obesity also significantly reduced ECG specificity, because of significantly higher prevalence of LV remodeling (no LVH but increased mass-to-volume ratio) in obese subjects without LVH (36% vs 16%, P<0.05), which correlated with higher mean ECG LVH criteria values. Obesity-specific partition values were generated at fixed 95% specificity; Cornell voltage had highest sensitivity in non-obese (56%) and Sokolow-Lyon product in obese patients (24%). Obesity significantly lowers ECG sensitivity at detecting LVH, by attenuating ECG LVH values, and lowers ECG specificity through changes associated with LV remodeling. Our obesity-specific ECG partition values could improve the diagnostic performance in obese patients with hypertension.

journal_name

J Hum Hypertens

authors

Rodrigues JC,McIntyre B,Dastidar AG,Lyen SM,Ratcliffe LE,Burchell AE,Hart EC,Bucciarelli-Ducci C,Hamilton MC,Paton JF,Nightingale AK,Manghat NE

doi

10.1038/jhh.2015.58

subject

Has Abstract

pub_date

2016-03-01 00:00:00

pages

197-203

issue

3

eissn

0950-9240

issn

1476-5527

pii

jhh201558

journal_volume

30

pub_type

杂志文章
  • Difference in carotid artery elasticity in subjects with different brachial artery kinetic of vasodilatation.

    abstract::Increased carotid stiffness and impaired brachial artery flow-mediated dilatation (FMD) associate with cardiovascular events. We have previously reported three FMD patterns based on the time of maximal dilatation. The aim of the present study was to verify whether different FMD patterns associate with carotid artery s...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:10.1038/jhh.2015.109

    authors: Tripolino C,Gnasso A,Carallo C,Scavelli FB,Irace C

    更新日期:2016-08-01 00:00:00

  • Blood pressure in young adults with and without a paternal history of premature coronary heart disease in Europe: the EARS Study. European Arteriosclerosis Study.

    abstract:OBJECTIVE:The European Arteriosclerosis Study (EARS) was designed to identify variables which discriminate subjects with a paternal history of premature coronary heart disease (CHD) from controls and to study the distribution of these variables across Europe. In this article we report on the blood pressure (BP) data. ...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:

    authors: Masana L,Farinaro E,De Henauw S,Nicaud V

    更新日期:1996-04-01 00:00:00

  • The electrocardiogram is an unreliable method of identifying left ventricular hypertrophy in stable, treated angina patients.

    abstract::In coronary artery disease (CAD), a potentially reversible factor leading to cardiac death is left ventricular hypertrophy (LVH). While the electrocardiogram (ECG) is a widely available way to diagnose LVH, its sensitivity and specificity has never been assessed in this particular patient group where added ischaemic c...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:10.1038/jhh.2008.18

    authors: Ang DS,Ti LL,Struthers AD

    更新日期:2008-06-01 00:00:00

  • Trends in coronary artery disease and associated risk factors in sub-Saharan Africans.

    abstract::It has been suggested that the prevalence of coronary artery disease (CAD) is steadily increasing in sub-Saharan Africa. To address this issue, we conducted a Medline search of English language articles on cardiovascular diseases-and specifically CAD in Africa- from 1966 to 1997. The prevalence of CAD and related comp...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:10.1038/sj.jhh.1001562

    authors: Akinboboye O,Idris O,Akinboboye O,Akinkugbe O

    更新日期:2003-06-01 00:00:00

  • Uric acid and the cardiovascular profile of African and Caucasian men.

    abstract::The African population is considered a high-risk group for the development of hypertension, and identifying risk factors are therefore essential in preventive actions against cardiovascular disease (CVD). Elevated levels of uric acid (UA) are often associated with CVD. Our first aim was to establish possible ethnic di...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:10.1038/jhh.2010.1

    authors: Palmer IM,Schutte AE,Huisman HW

    更新日期:2010-10-01 00:00:00

  • Acute influence of beta-adrenergic antagonists on left ventricular diastolic function: contrasting results after administration of celiprolol and metoprolol.

    abstract::Various beta-adrenergic receptor antagonists have different effects on myocardial function. A clinical study was performed in 30 patients with symptomatic coronary artery disease and systemic hypertension to compare the effects of single intravenous doses of 0.15 mg/kg celiprolol (n = 16) (third generation beta-blocki...

    journal_title:Journal of human hypertension

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Modersohn D,Franz N,Heublein B,Panzner B,Walde T,Bruch L

    更新日期:1994-02-01 00:00:00

  • Insertion/deletion polymorphism of the angiotensin-converting enzyme gene and loss of the insertion allele in aldosterone-producing adenoma.

    abstract::The genetic mechanisms responsible for the formation of adrenocortical adenomas which autonomously produce aldosterone are largely unknown. The adrenal renin-angiotensin system has been implicated in the pathophysiology of these tumours. Angiotensin-converting enzyme (ACE) catalyses the generation of angiotensin II, a...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:

    authors: Tunny TJ,Xu L,Richardson KA,Stowasser M,Gartside M,Gordon RD

    更新日期:1996-12-01 00:00:00

  • Targeting mechanisms of hypertensive vascular disease with dual calcium channel and renin-angiotensin system blockade.

    abstract::Patients with hypertension, particularly those with diabetes mellitus, are at heightened risk for cardiovascular and renal disease. Accumulated evidence indicates that the majority of hypertensive patients at high risk will require more than one antihypertensive agent to reach their blood pressure (BP) target. A reaso...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章,评审

    doi:10.1038/sj.jhh.1002254

    authors: Weir MR

    更新日期:2007-10-01 00:00:00

  • Factors influencing the development of malignant hypertension in Nigeria.

    abstract::Hypertension prevalence rates remain comparatively low in Nigeria, although the associated morbidity and mortality including that due to malignant hypertension (MHT) is considerable. To determine the factors that may be associated with the development of MHT we compared 74 patients with essential MHT (age 48 +/- 9 yea...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:10.1038/sj.jhh.1000963

    authors: Kadiri S,Olutade BO,Osobamiro O

    更新日期:2000-03-01 00:00:00

  • Microalbuminuria as an early marker of severity in hypertensive pregnant women.

    abstract::The value of microalbuminuria in predicting hypertensive complications in pregnant patients at high risk was tested in a prospective trial. A total of 276 patients were studied (142 in the study group vs 134 controls). Albumin was measured in 8-h overnight urine collection throughout pregnancy using radioimmunoassay t...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:

    authors: Bar J,Friedman S,Erman A,Kaplan B,Hod M,Boner G,Ovadia J

    更新日期:1996-09-01 00:00:00

  • Genomic regions that influence plasma levels of inflammatory markers in hypertensive sibships.

    abstract::We carried out univariate and bivariate linkage analyses to identify genomic regions that may influence plasma levels of C-reactive protein (CRP) and fibrinogen and exert pleiotropic effects on both traits. Subjects included African American (AA, n=1310, mean age 62.7+/-9.4 years) and non-Hispanic white (NHW, n=796, m...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:10.1038/sj.jhh.1002297

    authors: Ding K,Feng D,de Andrade M,Mosley TH Jr,Turner ST,Boerwinkle E,Kullo IJ

    更新日期:2008-02-01 00:00:00

  • Cholesterol:phospholipid ratio is elevated in platelet plasma membrane in patients with hypertension.

    abstract::The cholesterol:phospholipid ratio was measured in platelet plasma membrane, red blood cell (RBC) membranes, low density lipoprotein (LDL) and whole plasma in patients with primary hypertension and in matched normal controls. The cholesterol:phospholipid ratio was raised in the platelet membrane from hypertensive pati...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:

    authors: Benjamin N,Robinson BF,Graham JG,Wilson RB

    更新日期:1990-06-01 00:00:00

  • Red meat, poultry, and egg consumption with the risk of hypertension: a meta-analysis of prospective cohort studies.

    abstract::The objective of this study was to examine the associations of red meat, poultry, and egg consumption with the risk of hypertension (HTN). The electronic databases of PubMed, Web of Science, and Embase were searched up to August 2017, for prospective cohort studies on the associations between red meat, poultry, or egg...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章,meta分析

    doi:10.1038/s41371-018-0068-8

    authors: Zhang Y,Zhang DZ

    更新日期:2018-07-01 00:00:00

  • Arterial properties of early hypertension.

    abstract::In addition to high blood pressure, hypertension is characterised by metabolic and cardiovascular abnormalities, including decreased arterial compliance. To evaluate arterial involvement in early hypertension, we have employed a technique that analyses the arterial pulse wave contour to separately quantify proximal co...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:

    authors: Weber MA,Smith DH,Neutel JM,Graettinger WF

    更新日期:1991-10-01 00:00:00

  • Left ventricular hypertrophy and cognitive function: a systematic review.

    abstract::Cognitive impairment is common in patients with hypertension. Left ventricular hypertrophy (LVH) is recognised as a marker of hypertension-related organ damage and is a strong predictor of coronary artery disease, heart failure and stroke. There is evidence that LVH is independently associated with cognitive impairmen...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:10.1038/s41371-017-0023-0

    authors: Restrepo C,Patel SK,Rethnam V,Werden E,Ramchand J,Churilov L,Burrell LM,Brodtmann A

    更新日期:2018-03-01 00:00:00

  • Increased central arterial stiffness and altered cerebrovascular haemodynamic properties in South Asian older adults.

    abstract::South Asians (SA) suffer from a higher burden of heart disease and stroke compared with White Caucasians (CA). We hypothesized that increased arterial stiffness in older adults of SA origin would be associated with greater cerebrovascular pulsatile pressure and flow characteristics compared with CA older adults. Forty...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:10.1038/jhh.2015.76

    authors: Brar I,Robertson AD,Hughson RL

    更新日期:2016-05-01 00:00:00

  • Enhanced vasodilator responses to calcitonin gene-related peptide (CGRP) in subcutaneous arteries in human hypertension.

    abstract::Isolated segments (1-2 mm) of small subcutaneous arteries (diameter 0.1-0.9 mm) and veins (0.1-1.0 mm) from patients with hypertension (essential n = 13, renovascular n = 6) and controls (n = 17) were examined. The relaxant responses to the sensory transmitters calcitonin gene-related peptide (CGRP) and substance P, a...

    journal_title:Journal of human hypertension

    pub_type: 临床试验,杂志文章

    doi:10.1038/sj.jhh.1001294

    authors: Lind H,Edvinsson L

    更新日期:2002-01-01 00:00:00

  • Impact of the renin-angiotensin-aldosterone system on blood pressure response to intravenous enalaprilat in patients with hypertensive crises.

    abstract::The purpose of the study was to evalute the impact of the renin-angiotensin-aldosterone (RAA) system on blood pressure (BP) response in patients with hypertensive emergencies and urgencies treated with intravenous enalaprilat. Thirty-five patients with a systolic BP (SBP) >210 mm Hg and/or diastolic BP (DBP) >110 mm H...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:10.1038/sj.jhh.1000404

    authors: Hirschl MM,Binder M,Bur A,Herkner H,Woisetschläger C,Bieglmayer C,Laggner AN

    更新日期:1997-03-01 00:00:00

  • Lack of effect on blood pressure by low fat diets with different fatty acid compositions.

    abstract::We compared the effects on blood pressure (BP) of three isocaloric diets with reduced total fat and saturated fatty acid (SAFA) contents but with different proportions of monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA). Diet LF (low fat) provided 20 en% fat (7.9% SAFA, 7.8% MUFA, 3.0% PUFA); diet HP (hig...

    journal_title:Journal of human hypertension

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1038/sj.jhh.1000610

    authors: Aro A,Pietinen P,Valsta LM,Salminen I,Turpeinen AM,Virtanen M,Dougherty RM,Iacono JM

    更新日期:1998-06-01 00:00:00

  • Sagittal abdominal diameter is associated with insulin sensitivity in Chinese hypertensive patients and their siblings.

    abstract::The purpose of the study is to observe the relation between anthropometric measurements, focusing on sagittal abdominal diameter (SAD), and insulin sensitivity indices in Chinese hypertensive patients and their siblings. In total, 907 participants, 537 hypertensive and 370 nonhypertensive, from 311 Taiwanese families ...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章,多中心研究

    doi:10.1038/sj.jhh.1001532

    authors: Hwu CM,Hsiao CF,Sheu WH,Pei D,Tai TY,Quertermous T,Rodriguez B,Pratt R,Chen YD,Ho LT

    更新日期:2003-03-01 00:00:00

  • Lisinopril in the treatment of hypertension.

    abstract::Established essential hypertension is characterised haemodynamically by a normal cardiac output and elevated total peripheral resistance. As hypertensive cardiovascular disease progresses, and the patient grows older, cardiac output falls and total peripheral resistance is further elevated. The activity of the renin-a...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章,评审

    doi:

    authors: Messerli FH,Kaesser UR

    更新日期:1989-06-01 00:00:00

  • The relationship between aortic stiffness and changes in retinal microvessels among Asian ischemic stroke patients.

    abstract::Large-artery stiffness is a risk factor for stroke, including cerebral small-vessel disease. Retinal microvascular changes are thought to mirror those in cerebral microvessels. We investigated the relationship between aortic stiffness and retinal microvascular changes in Asian ischemic stroke patients. We studied 145 ...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:10.1038/jhh.2011.88

    authors: De Silva DA,Woon FP,Manzano JJ,Liu EY,Chang HM,Chen C,Wang JJ,Mitchell P,Kingwell BA,Cameron JD,Lindley RI,Wong TY,Wong MC,behalf of the Multi-Centre Retinal Stroke Study Collaborative Group.

    更新日期:2012-12-01 00:00:00

  • Hypertension prevalence, awareness, treatment and control in Dakar (Senegal).

    abstract::The prediction of risk profile trends associated with non-communicable diseases in developing countries is among the greatest global health challenges. The aim of this study is to estimate prevalence, awareness, treatment and control of hypertension in Dakar (Senegal). This study was carried out between January and Ju...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:10.1038/jhh.2013.142

    authors: Duboz P,Boëtsch G,Gueye L,Macia E

    更新日期:2014-08-01 00:00:00

  • Resistant hypertension, obstructive sleep apnoea and aldosterone.

    abstract::Obstructive sleep apnoea (OSA) and hypertension commonly coexist. Observational studies indicate that untreated OSA is strongly associated with an increased risk of prevalent hypertension, whereas prospective studies of normotensive cohorts suggest that OSA may increase the risk of incident hypertension. Randomized ev...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章,评审

    doi:10.1038/jhh.2011.47

    authors: Dudenbostel T,Calhoun DA

    更新日期:2012-05-01 00:00:00

  • The impact of blood pressure measurement methods on the assessment of differences in blood pressure levels between patients with normoalbuminuric type 1 diabetes and healthy controls.

    abstract::The aim of the study was to investigate the impact of various blood pressure (BP) measurement methods on the assessment of differences in BP levels between patients with normoalbuminuric type 1 diabetes and healthy controls. We measured intra-arterial BP (i.a.), sphygmomanometric BP (sphygmo), 24-h ambulatory blood pr...

    journal_title:Journal of human hypertension

    pub_type: 临床试验,杂志文章

    doi:10.1038/sj.jhh.1000776

    authors: Vervoort G,Wetzels JF,Lutterman JA,Berden JH,Thien T,Smits P

    更新日期:1999-02-01 00:00:00

  • Non-resectable phaeochromocytoma: long term follow-up.

    abstract::A forty-two year old woman presented with hypertension, trembling, sweating, visual impairment, headache and weight loss. A right adrenal phaeochromocytoma was diagnosed. The tumour could not be resected because it encircled the inferior vena cava. She was treated at first with phenoxybenzamine and propranolol and lat...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:

    authors: Pelegrí A,Romero R,Reguant M,Aisa L

    更新日期:1989-04-01 00:00:00

  • Trends in hypertension epidemiology in India.

    abstract::Cardiovascular diseases caused 2.3 million deaths in India in the year 1990; this is projected to double by the year 2020. Hypertension is directly responsible for 57% of all stroke deaths and 24% of all coronary heart disease deaths in India. Indian urban population studies in the mid-1950s used older WHO guidelines ...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章,评审

    doi:10.1038/sj.jhh.1001633

    authors: Gupta R

    更新日期:2004-02-01 00:00:00

  • Blood pressure and other risk factors before the onset of myocardial infarction in hypertensive patients.

    abstract::To investigate blood pressure (BP) as well as other risk factors before the onset of myocardial infarction in hypertensive patients, we analysed the BP and metabolic variables in 94 hypertensive patients who had been followed up in our out-patient clinic before the first onset (M1 group; n = 42, 69 +/- 1 years, mean +...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:10.1038/sj.jhh.1000697

    authors: Minami J,Kawano Y,Nonogi H,Ishimitsu T,Matsuoka H,Takishita S

    更新日期:1998-10-01 00:00:00

  • Serum gamma-glutamyl transferase level in predicting hypertension among male drinkers.

    abstract::In a 10 year prospective study, we investigated the utility of the level of serum gamma-glutamyl transferase (GGT), a biological marker of alcohol consumption, in predicting the development of hypertension in Japanese male drinkers, all of whom lived in a rural community. The study included 77 men, aged 30-69 years, w...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章

    doi:

    authors: Miura K,Nakagawa H,Nakamura H,Tabata M,Nagase H,Yoshida M,Kawano S

    更新日期:1994-06-01 00:00:00

  • Hypertension in women.

    abstract::Hypertension in women has received less attention than hypertension in men, and the major controlled trials of antihypertensive therapy have been carried out in populations made up predominantly of and have emphasised outcomes in men. Recently it has been recognised that women develop high blood pressure, particularly...

    journal_title:Journal of human hypertension

    pub_type: 杂志文章,评审

    doi:10.1038/sj.jhh.1001095

    authors: Rosenthal T,Oparil S

    更新日期:2000-10-01 00:00:00