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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Reliability of electrocardiographic surrogates of left ventricular mass in patients with chronic kidney disease

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Cordeiro, Antonio C. [1, 2, 3] ; Lindholm, Bengt [1, 3] ; Sousa, Marcio G. [2] ; Picotti, Juliano C. [4] ; Nunes, Gabriel J. [4] ; Santana, Marcus R. O. [4] ; Grimaldi, Jr., Waldyr [4] ; Amparo, Fernanda C. [5] ; Amodeo, Celso [2] ; Carrero, Juan J. [1, 6, 3]
Total Authors: 10
[1] Karolinska Inst, Dept Clin Sci Intervent & Technol, Div Renal Med, Stockholm - Sweden
[2] Dante Pazzanese Inst Cardiol, Dept Hypertens & Nephrol, BR-04012909 Sao Paulo - Brazil
[3] Karolinska Inst, Dept Clin Sci Intervent & Technol, Div Baxter Novum, Stockholm - Sweden
[4] Dante Pazzanese Inst Cardiol, Dept Echocardiog, BR-04012909 Sao Paulo - Brazil
[5] Dante Pazzanese Inst Cardiol, Dept Nutr, BR-04012909 Sao Paulo - Brazil
[6] Karolinska Inst, Ctr Mol Med, Stockholm - Sweden
Total Affiliations: 6
Document type: Journal article
Source: Journal of Hypertension; v. 32, n. 2, p. 439-445, FEB 2014.
Web of Science Citations: 9

Objective:Left ventricular hypertrophy (LVH) is a prevalent condition in chronic kidney disease (CKD) very often underdiagnosed and misdiagnosed. Electrocardiography (ECG) is an easily accessible LVH diagnostic tool. We evaluated the usefulness of commonly applied ECG criteria for LVH diagnosis in CKD patients.Methods:Cross-sectional evaluation of 253 nondialysis-dependent CKD stages 3-5 patients (61 {[}53-67] years; 65% men). Left ventricular mass (LVM) was assessed by echocardiography (ECHO). ECG was performed to assess Cornell voltage and Sokolow-Lyon voltage and their products (Cornell product and Sokolow-Lyon product, respectively).Results:The prevalence of LVH ranged from 72 to 89% depending on ECHO criteria used. Cornell product showed the best correlation with ECHO-estimated LVM (=0.41; P<0.001). Across sex-specific tertiles of ECHO-LVM, ECG criteria increased and patients were more often hypertensive, obese, fluid overloaded, inflamed, and with higher albuminuria. Cornell product showed the strongest association with ECHO-LVM in crude and adjusted regression models, and the higher predictive performance for all the ECHO-based LVH definitions. However, when applying literature-based ECG cut-offs for LVH diagnosis, Sokolow-Lyon product showed a higher specificity. The agreement between ECG criteria cut-offs and ECHO-based definitions of LVH was in general poor, and the number of patients reclassified correctly by ECHO ranged from 77 to 94%.Conclusion:Our data suggest that ECG alone is a weak indicator of LVH, and do not support its routine use as a unique tool in the screening of LVH in CKD patients. Further studies are needed to confirm these results and to try establishing adequate cut-offs for LVH diagnosis in this population. (AU)

FAPESP's process: 10/16593-2 - Association between traditional, novel and uremic related risk factors and morbidity/mortality (all-cause and cardiovascular) in chronic kidney disease patients
Grantee:Antonio Carlos Cordeiro Silva Júnior
Support type: Regular Research Grants