Accuracy of electrocardiography in diagnosis of left ventricular hypertrophy in arterial hypertension: systematic review

摘要: Objective To review the accuracy of electrocardiography in screening for left ventricular hypertrophy patients with hypertension. Design Systematic studies test six electrocardiographic indexes: Sokolow-Lyon index, Cornell voltage product Gubner and Romhilt-Estes scores thresholds a positive ≥4 points or ≥5 points. Data sources Electronic databases ((Pre-)Medline, Embase), reference lists relevant previous reviews, experts. Study selection Two reviewers scrutinised abstracts examined potentially eligible studies. Studies comparing index echocardiography hypertensive reporting sufficient data were included. extraction on study populations, echocardiographic criteria, methodological quality extracted. synthesis Negative likelihood ratios, which indicate to what extent posterior odds is reduced by negative test, calculated. Results 21 5608 analysed. The median prevalence was 33% (interquartile range 23-41%) primary care settings (10 studies) 65% (37-81%) secondary (11 studies). ratio similar across indexes, ranging from 0.85 (range 0.34-1.03) score (with threshold points) 0.91 (0.70-1.01) index. Using care, electrocardiogram result would reduce typical pre-test probability 31%. In be 63%. Conclusion Electrocardiographic criteria should not used rule out