open access

Vol 14, No 1 (2019)
Young Cardiology
Published online: 2019-04-10
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Electrocardiography for the diagnosis of left ventricular hypertrophy in end-stage renal disease treated with haemodialysis

Agnieszka Szramowska, Katarzyna Kurnicka, Marek Roik, Marcin Koć, Andrzej Łabyk, Olga Zdończyk, Maksymilian Bielecki, Piotr Bienias, Aisha Ou-Pokrzewińska, Mirosław Grzeszczyk, Marek Cacko, Piotr Pruszczyk
DOI: 10.5603/FC.2019.0008
·
Folia Cardiologica 2019;14(1):24-29.

open access

Vol 14, No 1 (2019)
Young Cardiology
Published online: 2019-04-10

Abstract

Introduction. Left ventricular hypertrophy (LVH) is one of the most common cardiovascular risk factors in patients under- going haemodialysis (HD). Although standard ECG can help to identify patients at greater risk of LVH, its prognostic value in haemodialysed patients is uncertain. This study aimed to evaluate currently used ECG criteria for LVH in patients on renal replacement therapy.  Material and methods. A group of 90 patients, who were undergoing qualification to renal transplantation, were included in the study. Every patient underwent 12-lead ECG and transthoracic echocardiography. Patients with any conduction disorders were excluded from the study. Finally, the study group consisted of 76 patients (21 women, mean age 53.1 ± 14.4 years).  Results. LVH was diagnosed by echocardiography in 39 patients (51%, 27 men and 12 women). Only three out of six tested criteria showed satisfactory performance for LVH diagnosis in HD patients: the sum of S V3 and R aVL > 28 mm in men, and > 20 mm in women (area under curve [AUC] 68%, 95% confidence interval [CI] 56–80); the sum of S V1 and R V5 or V6 > 35 mm (AUC 63%, 95%CI 50–76); and the sum of SV2 and RV5 or V6 > 45 mm (AUC 63%; 95%CI 50–75).  Conclusions. The present ECG diagnostic criteria for LVH are of very limited value in patients undergoing HD. Further studies should be performed to establish new ECG criteria for this group of patients. In the meantime, echocardiography should be recommended as the most precise diagnostic routine test to evaluate HD patients for LVH. 

Abstract

Introduction. Left ventricular hypertrophy (LVH) is one of the most common cardiovascular risk factors in patients under- going haemodialysis (HD). Although standard ECG can help to identify patients at greater risk of LVH, its prognostic value in haemodialysed patients is uncertain. This study aimed to evaluate currently used ECG criteria for LVH in patients on renal replacement therapy.  Material and methods. A group of 90 patients, who were undergoing qualification to renal transplantation, were included in the study. Every patient underwent 12-lead ECG and transthoracic echocardiography. Patients with any conduction disorders were excluded from the study. Finally, the study group consisted of 76 patients (21 women, mean age 53.1 ± 14.4 years).  Results. LVH was diagnosed by echocardiography in 39 patients (51%, 27 men and 12 women). Only three out of six tested criteria showed satisfactory performance for LVH diagnosis in HD patients: the sum of S V3 and R aVL > 28 mm in men, and > 20 mm in women (area under curve [AUC] 68%, 95% confidence interval [CI] 56–80); the sum of S V1 and R V5 or V6 > 35 mm (AUC 63%, 95%CI 50–76); and the sum of SV2 and RV5 or V6 > 45 mm (AUC 63%; 95%CI 50–75).  Conclusions. The present ECG diagnostic criteria for LVH are of very limited value in patients undergoing HD. Further studies should be performed to establish new ECG criteria for this group of patients. In the meantime, echocardiography should be recommended as the most precise diagnostic routine test to evaluate HD patients for LVH. 
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Keywords

left ventricular hypertrophy; electrocardiography; end-stage renal disease; haemodialysis; renal replacement therapy

About this article
Title

Electrocardiography for the diagnosis of left ventricular hypertrophy in end-stage renal disease treated with haemodialysis

Journal

Folia Cardiologica

Issue

Vol 14, No 1 (2019)

Pages

24-29

Published online

2019-04-10

DOI

10.5603/FC.2019.0008

Bibliographic record

Folia Cardiologica 2019;14(1):24-29.

Keywords

left ventricular hypertrophy
electrocardiography
end-stage renal disease
haemodialysis
renal replacement therapy

Authors

Agnieszka Szramowska
Katarzyna Kurnicka
Marek Roik
Marcin Koć
Andrzej Łabyk
Olga Zdończyk
Maksymilian Bielecki
Piotr Bienias
Aisha Ou-Pokrzewińska
Mirosław Grzeszczyk
Marek Cacko
Piotr Pruszczyk

References (11)
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