• Cardiology Clinical Trials
• Hypertensive Disease
• Cardiac Imaging Techniques
• Imaging Modalities

The performance of the Cornell or Sokolow-Lyon voltage criteria, which were established in the developed world from populations of vastly different ethnic backgrounds, has not been evaluated for the detection of left ventricular hypertrophy (LVH) in Trinidadians. In the first study of its kind to be conducted in Trinidad, the estimated prevalence of LVH appears to be relatively high if ECG is the single investigation that is performed. However, it approaches a value that is similar to that in the literature when echocardiography (ECHO) is performed. Romel Bacchus, MD, University of West Indies, Mt. Hope, Trinidad, presented poster data that showed the value of using ECHO in individuals who are suspected of having LVH.

LVH is an independent predictor of cardiovascular morbidity and mortality and can occur in normotensive individuals or those without any recognized underlying pathology. Healthy participants (n=209) with normal blood pressure (<140/90 mm Hg), no previous history of type 2 diabetes or hypertension, or no existing LVH that is confirmed by ECHO were enrolled in a cross-sectional study. The study participants (mostly women in their mid-30s) consisted of Southeast Asians, Africans, and those of mixed descent.

Using ECG and the Sokolow-Lyon criteria, 10.5% of normotensives were diagnosed with LVH, while ECG and the Cornel criteria detected 5.3%. Using the American Society of Echocardiography criteria and World Health Organization criteria, ECHO confirmed the diagnosis of LVH in 2.9% and 1.5% of normotensive individuals, respectively, in both ECG groups. Pearson's correlation coeffficient indicated that the Cornel criteria were a more accurate measurement of LVH compared with the Sokolow-Lyon criteria.

Although limited by its small sample size, this study suggests that ECHO should be used for all patients who are suspected of having LVH. The low pretest probability of LVH in this cohort, largely comprising women in their mid-30s, may have impacted test performance. Larger studies that involve a broader group of patients are recommended.

• © 2011 MD Conference Express