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Factors associated with diagnostic discrepancy for left ventricular hypertrophy between electrocardiography and echocardiography

Petersen, Søren Sandager; Pedersen, Line Reinholdt; Pareek, Manan; Nielsen, Mette Lundgren; Diederichsen, Søren Zöga; Leósdóttir, Margrét LU ; Nilsson, Peter M. LU ; Diederichsen, Axel Cosmus Pyndt and Olsen, Michael Hecht (2017) In Blood Pressure 26(1). p.54-63
Abstract

Objective: To investigate the influence of cardiovascular risk factors, including fasting plasma glucose (FPG), on the association between electrocardiographic (ECG) and echocardiographic left ventricular hypertrophy (LVH) in an elderly population. Methods: We tested cross-sectional associations between electrocardiographic and echocardiographic LVH, defining LVH according to the Sokolow-Lyon voltage combination, Cornell voltage-duration product, or left ventricular mass index (LVMI). Differences between standardized LVMI and Sokolow-Lyon voltage combination or Cornell voltage-duration product (absolute value/cut-off value for LVH) were used as outcome variables in order to identify explanatory variables associated with diagnostic... (More)

Objective: To investigate the influence of cardiovascular risk factors, including fasting plasma glucose (FPG), on the association between electrocardiographic (ECG) and echocardiographic left ventricular hypertrophy (LVH) in an elderly population. Methods: We tested cross-sectional associations between electrocardiographic and echocardiographic LVH, defining LVH according to the Sokolow-Lyon voltage combination, Cornell voltage-duration product, or left ventricular mass index (LVMI). Differences between standardized LVMI and Sokolow-Lyon voltage combination or Cornell voltage-duration product (absolute value/cut-off value for LVH) were used as outcome variables in order to identify explanatory variables associated with diagnostic discrepancies between ECG and echocardiography. Results: Of the 1382 subjects included, 77% did not display any signs of LVH, 6% had LVH defined by ECG only, 13% had LVH defined by echocardiography only, and 5% had LVH on both ECG and echocardiography. Older subjects and those with higher blood pressure and RWT were more likely to have a relatively greater LVMI on echocardiography than that predicted on ECG (odds ratio: 1.65 per 10 years (95% confidence interval (CI): 1.27-2.15), p = .0002, odds ratio: 1.17 per 10 mmHg (95% CI: 1.09-1.25), p < .0001, and odds ratio: 1.21 per 0.10 (95% CI: 1.02-1.42), p = .03). In addition, discrepancy was also seen in females and subjects receiving antihypertensive medication (odds ratio: 1.41 (95% CI: 1.04-1.89), p = .03 and odds ratio: 1.41 (95% CI: 1.06-1.87), p = .02), but FPG did not independently influence discrepancy between ECG and echocardiography. Conclusion: Age, blood pressure, female sex, greater RWT and use of antihypertensive medication were associated with a greater risk of non-consistency between LVH determined by ECG and echocardiography.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Discrepancy, ECG, echocardiography, left ventricular hypertrophy, left ventricular mass
in
Blood Pressure
volume
26
issue
1
pages
54 - 63
publisher
Taylor & Francis
external identifiers
  • scopus:84988660457
  • wos:000392487000010
ISSN
0803-7051
DOI
10.1080/08037051.2016.1235959
language
English
LU publication?
yes
id
fc88e9b9-a029-44e9-9fe7-3bab61bd658f
date added to LUP
2016-10-24 16:00:19
date last changed
2018-01-07 11:31:50
@article{fc88e9b9-a029-44e9-9fe7-3bab61bd658f,
  abstract     = {<p>Objective: To investigate the influence of cardiovascular risk factors, including fasting plasma glucose (FPG), on the association between electrocardiographic (ECG) and echocardiographic left ventricular hypertrophy (LVH) in an elderly population. Methods: We tested cross-sectional associations between electrocardiographic and echocardiographic LVH, defining LVH according to the Sokolow-Lyon voltage combination, Cornell voltage-duration product, or left ventricular mass index (LVMI). Differences between standardized LVMI and Sokolow-Lyon voltage combination or Cornell voltage-duration product (absolute value/cut-off value for LVH) were used as outcome variables in order to identify explanatory variables associated with diagnostic discrepancies between ECG and echocardiography. Results: Of the 1382 subjects included, 77% did not display any signs of LVH, 6% had LVH defined by ECG only, 13% had LVH defined by echocardiography only, and 5% had LVH on both ECG and echocardiography. Older subjects and those with higher blood pressure and RWT were more likely to have a relatively greater LVMI on echocardiography than that predicted on ECG (odds ratio: 1.65 per 10 years (95% confidence interval (CI): 1.27-2.15), p = .0002, odds ratio: 1.17 per 10 mmHg (95% CI: 1.09-1.25), p &lt; .0001, and odds ratio: 1.21 per 0.10 (95% CI: 1.02-1.42), p = .03). In addition, discrepancy was also seen in females and subjects receiving antihypertensive medication (odds ratio: 1.41 (95% CI: 1.04-1.89), p = .03 and odds ratio: 1.41 (95% CI: 1.06-1.87), p = .02), but FPG did not independently influence discrepancy between ECG and echocardiography. Conclusion: Age, blood pressure, female sex, greater RWT and use of antihypertensive medication were associated with a greater risk of non-consistency between LVH determined by ECG and echocardiography.</p>},
  author       = {Petersen, Søren Sandager and Pedersen, Line Reinholdt and Pareek, Manan and Nielsen, Mette Lundgren and Diederichsen, Søren Zöga and Leósdóttir, Margrét and Nilsson, Peter M. and Diederichsen, Axel Cosmus Pyndt and Olsen, Michael Hecht},
  issn         = {0803-7051},
  keyword      = {Discrepancy,ECG,echocardiography,left ventricular hypertrophy,left ventricular mass},
  language     = {eng},
  month        = {01},
  number       = {1},
  pages        = {54--63},
  publisher    = {Taylor & Francis},
  series       = {Blood Pressure},
  title        = {Factors associated with diagnostic discrepancy for left ventricular hypertrophy between electrocardiography and echocardiography},
  url          = {http://dx.doi.org/10.1080/08037051.2016.1235959},
  volume       = {26},
  year         = {2017},
}