ASSESSMENT OF LEFT VENTRICULAR HYPERTROPHY IN PATIENTS WITH ESSENTIAL ARTERIAL HYPERTENSION IN A GENERAL PRACTICE

• Main Authors: Marija Petek Šter, Boris Krajačič
• Format: Article
• Language: English
• Published: Slovenian Medical Association 2004-12-01
• Series: Zdravniški Vestnik
• Subjects: arterial hypertension; left ventricular hypertrophy; target organ; ECG; family physician
• Online Access: http://vestnik.szd.si/index.php/ZdravVest/article/view/2386

<p>Background. The heart is a target organ in arterial hypertension. Echocardiography is the most valuable noninvasive method to assess the left ventricular hypertrophy. Patients with left ventricular hypertrophy constitute a group with high cardiovascular risk. Unfortunately, it is not affordable to all hypertensive patients treated in general practice. ECG still remains the basic method to evaluate the left ventricular hypertrophy. A selection of the most sensitive ECG criteria to evaluate left ventricular hypertrophy might improve the sensitivity of the method and thus recognize a sufficient proportion of the hypertensive patients with left ventricular hypertrophy, confirmed by echocardiography.</p><p>Patients and methods. We included 62 consecutive patients (31 male and 31 female) with essential arterial hypertension, treated in a single general practice. We made anamnesis, a complete clinical examination with eye fundi examination, usual laboratory examinations, 12-lead ECG and echocardiography. We applied the ECG criteria to evaluate left ventricular hypertrophy (Sokolow-Lyon index &gt; 38 mm, Cornell product &gt; 2440 mm*ms) and echocardiographic criteria (left ventricular mass for men at least 125 g/m2 and for women at least 110 g/m2).</p><p>Results. We found left ventricular hypertrophy in 13 (21.0%) patients by using the combination of both ECG criteria and in 39 (62.9%) by echocardiography. The sensitivity of the combined ECG criteria was 25.6%, the sensitivity of SokolowLyon index was 12.8% and the sensitivity of Cornell product was 17.9%. The specificity of Sokolow-Lyon index was 83%, Cornell product had 78% specificity and the combination of both criteria had specificity of 100%. The left ventricular hypertrophy confirmed by echocardiography was more prevalent in female patients (p = 0.035) and it showed statistically significant correlation with higher values of Sokolow-Lyon index and Cornell product (p &lt; 0.0005).</p><p>Conclusions. The combination of Sokolow-Lyon index and Cornell product yields higher sensitivity than each of them alone and enables us to recognize a higher percentage of hypertensive patients with actual left ventricular hypertrophy. Values of applied ECG criteria which are closer to the limit values signify a higher possibility for the left ventricular hypertrophy.<br /><br /><br /><br /></p>