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 Hypertensjournal_title
Journal of human hypertensionauthors
Rodrigues JC,McIntyre B,Dastidar AG,Lyen SM,Ratcliffe LE,Burchell AE,Hart EC,Bucciarelli-Ducci C,Hamilton MC,Paton JF,Nightingale AK,Manghat NEdoi
10.1038/jhh.2015.58subject
Has Abstractpub_date
2016-03-01 00:00:00pages
197-203issue
3eissn
0950-9240issn
1476-5527pii
jhh201558journal_volume
30pub_type
杂志文章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
更新日期:2016-08-01 00:00:00
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:
更新日期:1996-04-01 00:00:00
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
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journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:10.1038/sj.jhh.1001562
更新日期:2003-06-01 00:00:00
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
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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:
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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:
更新日期:1996-12-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 杂志文章,评审
doi:10.1038/sj.jhh.1002254
更新日期:2007-10-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:10.1038/sj.jhh.1000963
更新日期:2000-03-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1996-09-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:10.1038/sj.jhh.1002297
更新日期:2008-02-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1990-06-01 00:00:00
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
更新日期:2018-07-01 00:00:00
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:
更新日期:1991-10-01 00:00:00
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
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journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:10.1038/jhh.2015.76
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journal_title:Journal of human hypertension
pub_type: 临床试验,杂志文章
doi:10.1038/sj.jhh.1001294
更新日期:2002-01-01 00:00:00
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
更新日期:1997-03-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章,多中心研究
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journal_title:Journal of human hypertension
pub_type: 杂志文章,评审
doi:
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journal_title:Journal of human hypertension
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journal_title:Journal of human hypertension
pub_type: 杂志文章
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更新日期:2014-08-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 杂志文章,评审
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更新日期:2012-05-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 临床试验,杂志文章
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更新日期:1999-02-01 00:00:00
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:
更新日期:1989-04-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 杂志文章,评审
doi:10.1038/sj.jhh.1001633
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journal_title:Journal of human hypertension
pub_type: 杂志文章
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journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 杂志文章,评审
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更新日期:2000-10-01 00:00:00