Diagnostic efficacy and influencing factors of a new standard for diagnosis of left ventricular hypertrophy in Chinese population

  AIM  To verify the diagnostic efficacy of S_D+SV₄ criterion for left ventricular hypertrophy (LVH) in the Chinese population and to analyze the factors influencing its diagnostic accuracy.

  METHODS  Patients with hypertension who were treated in our hospital from January 2017 to December 2019 were included. The left ventricular mass index (LVMI) calculated with echocardiographic parameters was used as the gold standard for diagnosing LVH in this study. The receiver operating curve (ROC) curve was used to evaluate the efficacy of S_D+SV₄, RavL+SV₃ and SV₁+RV₅/RV₆ criteria in diagnosing LVH. Moreover, multivariate logistic regression analysis was used to evaluate the factors influencing the accuracy of the S_D+SV₄ standard in diagnosing LVH.

  RESULTS  A total of 477 patients were included in this study, with an average age of 59 ±14 years. Based on LVMI, 139 (29.1%) patients were diagnosed with LVH. In women patients, the area under curve (AUC) of the S_D+SV₄ criterion was significantly higher than those of the RavL+SV₃ (0.847 vs. 0.728, P<0.05) and SV₁+ RV₅/RV₆ criteria (0.847 vs. 0.706, P<0.05), and its sensitivity (79.2 %) and the specificity (94.4 %) were also higher than those of the other two diagnostic criteria. In men patients, there were no significant difference between the AUC of S_D+SV₄ criterion and the other two criteria. After adjusting for other factors, only the left ventricular ejection fraction (LVEF) (OR = 0.930, 95% CI 0.902~0.961, P<0.01) had significant differences in the consistency of the S_D+SV₄ criterion and the gold standard in the diagnosis of LVH. CONCLUSION The newly proposed S_D+SV₄ standard is better than the traditional electrocardiogram standard in diagnosing LVH. Decreased LVEF is an independent factor for the accuracy in diagnosing LVH.