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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1354364
This article is part of the Research Topic The Role of Electrocardiogram in Prediction of Cardiovascular and non-Cardiovascular Health Outcomes View all 6 articles

Clinical utility of electrocardiographic voltage parameters for the diagnosis of hypertrophic cardiomyopathy

Provisionally accepted
Gui Li Gui Li Lingdan Jin Lingdan Jin Zhiyuan Weng Zhiyuan Weng Xueqing Jin Xueqing Jin Xiaoyan Lin Xiaoyan Lin Shuling Chen Shuling Chen *
  • First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China

The final, formatted version of the article will be published soon.

    Background: While electrocardiographic parameters of hypertensive left ventricular hypertrophy (H-LVH) are well known, limited data are available regarding hypertrophic cardiomyopathy (HCM). This study was to assess the diagnostic value of electrocardiographic voltage parameters in HCM. Methods: Included patients with HCM treated between March 2015 and May 2023. Voltage parameters (S-L, Cornell, Cornell product, Lewis, Peguero, and modified Cornell voltages) and echocardiography were evaluated. Receiver operating characteristic (ROC) curves were used to assess the diagnostic value of electrocardiogram in HCM. The multiple linear regression was conducted to analyze the correlation between electrocardiogram indicators and cardiac diastolic function. Results: The highest sensitivity for HCM was Peguero voltage (70.4%; 88.6% specificity). The Peguero voltage had high sensitivity in male (63.8%) and female patients (84.9%), those aged <65 years (71.6%) and >65 years (68.3%), with non-apical HCM (AHCM) (76.7%), obstructive HCM (82.1%), and non-obstructive HCM (66.9%). The sensitivity of the S-L voltage was high in AHCM (72.2%). The sensitivity for HCM reached 88.7% when the S-L and Peguero voltages were combined. The modified Cornell index had the highest area under the curve (0.88, 95%CI: 0.84-0.91), and its optimal cutoff value was 2.05 mV in males (77.6% sensitivity and 74% specificity) and 1.935 mV in females (90.6% sensitivity and 91.4% specificity). Peguero voltage (beta = 0.154, P =0.034) and SD (beta = 0.223 P =0.004) were independently correlated with E/e', an index of left ventricular diastolic function. Conclusion: The Peguero voltage had high sensitivity and specificity for detecting the presence of HCM. It was positively correlated with E/e' in patients with HCM. For AHCM, the S-L voltage was more advantageous. Combining the S-L voltage with the Peguero voltage further improves the sensitivity for HCM and thus could be used to improve the screening of HCM in clinical practice. The SD and modified Cornell voltage also had good diagnostic performance, especially in females.

    Keywords: Electrocardiography, Sokolow-LyonS-L voltage, Peguero voltage, improved Cornellmodified cornellCornell voltage, Hypertrophic Cardiomyopathy

    Received: 11 Jan 2024; Accepted: 05 Sep 2024.

    Copyright: © 2024 Li, Jin, Weng, Jin, Lin and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Shuling Chen, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China

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