Questionable validity of left ventricular hypertrophy cutoff values in morbidly and super-morbidly obese patients

Ann Noninvasive Electrocardiol. 2018 Nov;23(6):e12564. doi: 10.1111/anec.12564. Epub 2018 Jun 17.

Abstract

Background: Current diagnostic ECG criteria of left ventricular hypertrophy in obese patients are still lacking.

Objective: To assess the current ECG diagnostic criteria of LVH, and to validate our previously proposed criteria in a group of patients with morbid obesity.

Methods: A group of consecutive 429 obese patients (MOP) with BMI of at least 35 kg/m2 (mean age 38.6 ± 8.9 years, BMI 48.7 ± 9.0 kg/m2 ; 323 females, 106 males) were included.

Results: The diagnosis of LVH in MOPs was confirmed only by RaVL of 7.5 mm, Cornell index of 12.5 mm; Cornell index × QRS duration of 1,125 mm × ms and Romhilt-Estes score of 1. None of the criteria proposed to date is appropriate in super-morbidly obese patients.

Conclusion: Our study confirmed that none of the currently used voltage-based ECG criteria is appropriate for diagnosing LVH in morbidly obese patients. Further studies are required.

Keywords: Noninvasive techniques - ECHO < Clinical; Noninvasive techniques - electrocardiography < Clinical.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Area Under Curve
  • Body Mass Index*
  • Cohort Studies
  • Echocardiography / methods*
  • Electrocardiography / methods*
  • Female
  • Humans
  • Hypertrophy, Left Ventricular / diagnostic imaging*
  • Hypertrophy, Left Ventricular / epidemiology
  • Hypertrophy, Left Ventricular / physiopathology
  • Male
  • Middle Aged
  • Needs Assessment
  • Obesity, Morbid / diagnosis*
  • Obesity, Morbid / epidemiology
  • ROC Curve
  • Reproducibility of Results
  • Sensitivity and Specificity