TY - JOUR
T1 - Left ventricular hypertrophy identified by cardiac computed tomography and ECG in hypertensive individuals
T2 - a population-based study
AU - Kühl, Jørgen Tobias
AU - Nielsen, Jonas Bille
AU - Stisen, Zara Rebecca
AU - Fuchs, Andreas
AU - Sigvardsen, Per Ejlstrup
AU - Graff, Claus
AU - Nordestgaard, Børge Grønne
AU - Køber, Lars Valeur
AU - Kofoed, Klaus
PY - 2019/4
Y1 - 2019/4
N2 - Objectives: Screening of left ventricular hypertrophy (LVH) is a biomarker of organ damage in hypertensive individuals and associated with increased mortality. Cardiac computed tomography (CT) is widely expanding worldwide; however, the value of CT assessment of LVH is unknown. We aimed to identify individuals with LVH using both cardiac CT and electrocardiograms (ECG) and to explore potential differences between these phenotypical distinct diagnostic modalities. Methods: Participants in the Copenhagen General Population Study underwent 12-lead ECG and cardiac CT and were evaluated for the presence of LVH. Multiple ECG signs of LVH were compared with LVH by CT. Results: Out of 4942 participants, 1347 had untreated hypertension and in this group, 13% presented with anatomical LVH by CT and 10% by ECG with an overlap of 4%. ECG signs of LVH had negative predictive values between 87 and 89% compared with CT. Using a combination of the Sokolow-Lyon index, the Cornell voltage duration product and/or a Romhilt-Estes score at least 4, lead to an increased C-statistics (P < 0.001) compared with the use of any single ECG sign of LVH. Individuals with solely CT but not ECG signs of LVH had higher SBPs (152 vs. 144 mmHg, P < 0.001) and larger left atria (49 vs. 45 ml/m
2, P < 0.001) compared with individuals with solely ECG LVH. Conclusion: CT and ECG identifies LVH in 19% of hypertensive individuals with only a small diagnostic overlap. Commonly used ECG criteria for LVH cannot safely rule out the presence of anatomical LV organ damage.
AB - Objectives: Screening of left ventricular hypertrophy (LVH) is a biomarker of organ damage in hypertensive individuals and associated with increased mortality. Cardiac computed tomography (CT) is widely expanding worldwide; however, the value of CT assessment of LVH is unknown. We aimed to identify individuals with LVH using both cardiac CT and electrocardiograms (ECG) and to explore potential differences between these phenotypical distinct diagnostic modalities. Methods: Participants in the Copenhagen General Population Study underwent 12-lead ECG and cardiac CT and were evaluated for the presence of LVH. Multiple ECG signs of LVH were compared with LVH by CT. Results: Out of 4942 participants, 1347 had untreated hypertension and in this group, 13% presented with anatomical LVH by CT and 10% by ECG with an overlap of 4%. ECG signs of LVH had negative predictive values between 87 and 89% compared with CT. Using a combination of the Sokolow-Lyon index, the Cornell voltage duration product and/or a Romhilt-Estes score at least 4, lead to an increased C-statistics (P < 0.001) compared with the use of any single ECG sign of LVH. Individuals with solely CT but not ECG signs of LVH had higher SBPs (152 vs. 144 mmHg, P < 0.001) and larger left atria (49 vs. 45 ml/m
2, P < 0.001) compared with individuals with solely ECG LVH. Conclusion: CT and ECG identifies LVH in 19% of hypertensive individuals with only a small diagnostic overlap. Commonly used ECG criteria for LVH cannot safely rule out the presence of anatomical LV organ damage.
KW - ECG,computed tomography,hypertension,left ventricular hypertrophy,organ damage
KW - Computed tomography
KW - ECG
KW - Hypertension
KW - Left ventricular hypertrophy
KW - Organ damage
UR - http://www.scopus.com/inward/record.url?scp=85063234229&partnerID=8YFLogxK
U2 - 10.1097/HJH.0000000000001962
DO - 10.1097/HJH.0000000000001962
M3 - Journal article
SN - 0263-6352
VL - 37
SP - 739
EP - 746
JO - Journal of Hypertension
JF - Journal of Hypertension
IS - 4
ER -