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Limitations of Elec...
Limitations of Electrocardiography for Detecting Left Ventricular Hypertrophy or Concentric Remodeling in Athletes
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- Hedman, Kristofer, 1984- (author)
- Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Fysiologiska kliniken US,Stanford University, Stanford, USA
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- Moneghetti, Kegan J. (author)
- Stanford University, Stanford, USA
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- Hsu, David (author)
- Stanford University, Stanford, USA
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- Christle, Jeffrey W. (author)
- Stanford University, Stanford, USA
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- Patti, Alessandro (author)
- Stanford University, Stanford, USA; Univ Padua, Italy
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- Ashley, Euan (author)
- Stanford University, Stanford, USA
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- Hadley, David (author)
- Cardiac Insight Inc, WA USA
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- Haddad, Francois (author)
- Stanford University, Stanford, USA
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- Froelicher, Victor (author)
- Stanford University, Stanford, USA
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(creator_code:org_t)
- Elsevier, 2020
- 2020
- English.
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In: American Journal of Medicine. - : Elsevier. - 0002-9343 .- 1555-7162. ; 133:1, s. 123-132.e8
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https://liu.diva-por... (primary) (Raw object)
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https://doi.org/10.1...
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Abstract
Subject headings
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- BackgroundElectrocardiography (ECG) is used to screen for left ventricular hypertrophy (LVH), but common ECG-LVH criteria have been found less effective in athletes. The purpose of this study was to comprehensively evaluate the value of ECG for identifying athletes with LVH or a concentric cardiac phenotype.MethodsA retrospective analysis of 196 male Division I college athletes routinely screened with ECG and echocardiography within the Stanford Athletic Cardiovascular Screening Program was performed. Left-ventricular mass and volume were determined using echocardiography. LVH was defined as left ventricular mass (LVM) > 102 g/m²; a concentric cardiac phenotype as LVM-to-volume (M/V) ≥ 1.05 g/mL. Twelve-lead electrocardiograms including high-resolution time intervals and QRS voltages were obtained. Thirty-seven previously published ECG-LVH criteria were applied, of which the majority have never been evaluated in athletes. C-statistics, including area under the receiver operating curve (AUC) and likelihood ratios were calculated.ResultsECG lead voltages were poorly associated with LVM (r = 0.18-0.30) and M/V (r = 0.15-0.25). The proportion of athletes with ECG-LVH was 0%-74% across criteria, with sensitivity and specificity ranging between 0% and 91% and 27% and 99.5%, respectively. The average AUC of the criteria in identifying the 11 athletes with LVH was 0.57 (95% confidence interval [CI] 0.56-0.59), and the average AUC for identifying the 8 athletes with a concentric phenotype was 0.59 (95% CI 0.56-0.62).ConclusionThe diagnostic capacity of all ECG-LVH criteria were inadequate and, therefore, not clinically useful in screening for LVH or a concentric phenotype in athletes. This is probably due to the weak association between LVM and ECG voltage.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Athletes heart; electrocardiography (ECG); echocardiography; left ventricular mass (LVM); preparticipation evaluation
Publication and Content Type
- ref (subject category)
- art (subject category)
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