Comparison of Electrocardiographic Criteria for Identifying Left Ventricular Hypertrophy in Athletes from Different Sports Modalities
OBJECTIVES: In athletes, isolated electrocardiogram high voltage criteria are widely used to evaluate left ventricular hypertrophy, but positive findings are thought to represent normal electrocardiogram alterations. However, which electrocardiogram criterion can best detect left ventricular hypertr...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier España
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| Series: | Clinics |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322017000600343&lng=en&tlng=en |
| _version_ | 1828197185419739136 |
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| author | Nelson Samesima Luciene Ferreira Azevedo Luciana Diniz Nagem Janot De Matos Leandro Santini Echenique Carlos Eduardo Negrao Carlos Alberto Pastore |
| author_facet | Nelson Samesima Luciene Ferreira Azevedo Luciana Diniz Nagem Janot De Matos Leandro Santini Echenique Carlos Eduardo Negrao Carlos Alberto Pastore |
| author_sort | Nelson Samesima |
| collection | DOAJ |
| description | OBJECTIVES: In athletes, isolated electrocardiogram high voltage criteria are widely used to evaluate left ventricular hypertrophy, but positive findings are thought to represent normal electrocardiogram alterations. However, which electrocardiogram criterion can best detect left ventricular hypertrophy in athletes of various sport modalities remains unknown. METHODS: Five electrocardiogram criteria used to detect left ventricular hypertrophy were tested in 180 male athletes grouped according to their sport modality: 67% low-static and high-dynamic components and 33% high-static and high-dynamic components of exercise. The following echocardiogram parameters are the gold standard for diagnosing left ventricular hypertrophy: left ventricular mass index ≥134 g.m-2, relative wall thickness ≥0.42 mm, left ventricular diastolic diameter index ≥32 mm.m-2, septum wall thickness ≥13 mm, and posterior wall thickness ≥13 mm. Results for the various criteria were compared using the kappa coefficient. Significance was established at p<0.05. RESULTS: Fifty athletes (28%) presented with left ventricular hypertrophy according to electrocardiogram findings, with the following sensitivities and specificities, respectively: 38-53% and 79-83% (Perugia), 22-40% and 89-91% (Cornell), 24-29% and 90% (Romhilt-Estes), 68-87% and 20-23% (Sokolow-Lyon), and 0% and 99% (Gubner). The Perugia and Cornell criteria had higher negative predictive values for the low-static and high-dynamic subgroup. Kappa coefficients were higher for Romhilt-Estes, Cornell and Perugia criteria than for Sokolow-Lyon and Gubner criteria. CONCLUSION: All five evaluated criteria are inadequate for detecting left ventricular hypertrophy, but the Perugia, Cornell and Romhilt-Estes criteria are useful for excluding its presence. The Perugia and Cornell criteria were more effective at excluding left ventricular hypertrophy in athletes involved in a sport modality with low-static and high-dynamic component predominance. |
| first_indexed | 2024-04-12T10:15:22Z |
| format | Article |
| id | doaj.art-f854f63d779941bfb823ad546cd28021 |
| institution | Directory Open Access Journal |
| issn | 1980-5322 |
| language | English |
| last_indexed | 2024-04-12T10:15:22Z |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-f854f63d779941bfb823ad546cd280212022-12-22T03:37:14ZengElsevier EspañaClinics1980-532272634335010.6061/clinics/2017(06)03S1807-59322017000600343Comparison of Electrocardiographic Criteria for Identifying Left Ventricular Hypertrophy in Athletes from Different Sports ModalitiesNelson SamesimaLuciene Ferreira AzevedoLuciana Diniz Nagem Janot De MatosLeandro Santini EcheniqueCarlos Eduardo NegraoCarlos Alberto PastoreOBJECTIVES: In athletes, isolated electrocardiogram high voltage criteria are widely used to evaluate left ventricular hypertrophy, but positive findings are thought to represent normal electrocardiogram alterations. However, which electrocardiogram criterion can best detect left ventricular hypertrophy in athletes of various sport modalities remains unknown. METHODS: Five electrocardiogram criteria used to detect left ventricular hypertrophy were tested in 180 male athletes grouped according to their sport modality: 67% low-static and high-dynamic components and 33% high-static and high-dynamic components of exercise. The following echocardiogram parameters are the gold standard for diagnosing left ventricular hypertrophy: left ventricular mass index ≥134 g.m-2, relative wall thickness ≥0.42 mm, left ventricular diastolic diameter index ≥32 mm.m-2, septum wall thickness ≥13 mm, and posterior wall thickness ≥13 mm. Results for the various criteria were compared using the kappa coefficient. Significance was established at p<0.05. RESULTS: Fifty athletes (28%) presented with left ventricular hypertrophy according to electrocardiogram findings, with the following sensitivities and specificities, respectively: 38-53% and 79-83% (Perugia), 22-40% and 89-91% (Cornell), 24-29% and 90% (Romhilt-Estes), 68-87% and 20-23% (Sokolow-Lyon), and 0% and 99% (Gubner). The Perugia and Cornell criteria had higher negative predictive values for the low-static and high-dynamic subgroup. Kappa coefficients were higher for Romhilt-Estes, Cornell and Perugia criteria than for Sokolow-Lyon and Gubner criteria. CONCLUSION: All five evaluated criteria are inadequate for detecting left ventricular hypertrophy, but the Perugia, Cornell and Romhilt-Estes criteria are useful for excluding its presence. The Perugia and Cornell criteria were more effective at excluding left ventricular hypertrophy in athletes involved in a sport modality with low-static and high-dynamic component predominance.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322017000600343&lng=en&tlng=enECG CriteriaLeft Ventricular HypertrophyDynamic ExerciseStatic ExerciseCardiac Adaptation |
| spellingShingle | Nelson Samesima Luciene Ferreira Azevedo Luciana Diniz Nagem Janot De Matos Leandro Santini Echenique Carlos Eduardo Negrao Carlos Alberto Pastore Comparison of Electrocardiographic Criteria for Identifying Left Ventricular Hypertrophy in Athletes from Different Sports Modalities Clinics ECG Criteria Left Ventricular Hypertrophy Dynamic Exercise Static Exercise Cardiac Adaptation |
| title | Comparison of Electrocardiographic Criteria for Identifying Left Ventricular Hypertrophy in Athletes from Different Sports Modalities |
| title_full | Comparison of Electrocardiographic Criteria for Identifying Left Ventricular Hypertrophy in Athletes from Different Sports Modalities |
| title_fullStr | Comparison of Electrocardiographic Criteria for Identifying Left Ventricular Hypertrophy in Athletes from Different Sports Modalities |
| title_full_unstemmed | Comparison of Electrocardiographic Criteria for Identifying Left Ventricular Hypertrophy in Athletes from Different Sports Modalities |
| title_short | Comparison of Electrocardiographic Criteria for Identifying Left Ventricular Hypertrophy in Athletes from Different Sports Modalities |
| title_sort | comparison of electrocardiographic criteria for identifying left ventricular hypertrophy in athletes from different sports modalities |
| topic | ECG Criteria Left Ventricular Hypertrophy Dynamic Exercise Static Exercise Cardiac Adaptation |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322017000600343&lng=en&tlng=en |
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