Abstract
BackgroundArterial hypertension is a common disease with high prevalence in the general population. Left ventricular hypertrophy (LVH) is an independent risk factor in arterial hypertension. Electrocardiographic indices like the Sokolow-Lyon index (SLI) are recommended as diagnostic screening methods for LVH.We assessed the diagnostic performance of the SLI in a cohort of a large general population.MethodsWe used electrocardiographic and echocardiographic data from the prospective, population-based cohort study CARdio-vascular Disease, Living and Ageing in Halle (CARLA). Linear and logistic regression models were used to assess the association of SLI with LVH. To assess the impact of the body-mass-index (BMI), we performed interaction analyses.ResultsAUC of SLI to predict LVH was 55.3 %, sensitivity of the SLI was 5 %, specificity 97 %. We found a significant association of SLI after covariate-adjustment with echocardiographically detected LVH (increase of left-ventricular mass index, LVMI 7.0 g/m2 per 1 mV increase of SLI, p < 0.0001). However, this association was mainly caused by an association of SLI with the left-ventricular internal diameter (LVIDd, increase of 0.06 cm/m2 per 1 mV increase of SLI, p < 0.0001). In obese (BMI > 30 kg/m2) we found the strongest association with an increase of 9.2 g/m2 per 1 mV.ConclusionsAlthough statistically significant, relations of SLI and echocardiographic parameters of LVH were weak and mainly driven by the increase in LVIDd, implicating a more eccentric type of LVH in the collective. The relations were strongest when obese subjects were taken into account. Our data do not favour the SLI as a diagnostic screening test to identify patients at risk for LVH, especially in non-obese subjects without eccentric LVH.
Highlights
Arterial hypertension is a common disease with high prevalence in the general population
Data of the 1779 participants of the baseline investigation were included in the statistical analysis
Women had a mean systolic blood pressure (SBP) of 140.0 mmHg and mean diastolic blood pressure (DBP) of 82.5 mmHg
Summary
Arterial hypertension is a common disease with high prevalence in the general population. Left ventricular hypertrophy (LVH) is an independent risk factor in arterial hypertension. We assessed the diagnostic performance of the SLI in a cohort of a large general population. Arterial hypertension is a common disease with a prevalence of 30–45 % in the general population in Europe [1]. In patients with arterial hypertension, LVH initially serves as a compensatory mechanism of the heart to deal with the increased arterial pressure. In recent guidelines LVH is defined as an increase in left ventricular mass (LVM) > 115 g/m2 in men and > 95 g/m2 in women [1]. Increase of LVM is an independent risk factor in arterial hypertension. In patients with arterial hypertension without pre-existing cardiac disease and myocardial wall thickening, the 10-year mortality rate rises up from 1 to Schröder et al BMC Cardiovascular Disorders (2015) 15:69
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