Diagnostic Accuracy of ECG to Detect Left Ventricular Hypertrophy in Patients with Left Bundle Branch Block A Systematic Review and Meta-analysis

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorSOUZA, Isabela A. F. de
dc.contributor.authorPADRAO, Eduardo M. H.
dc.contributor.authorMARQUES, Isabela R.
dc.contributor.authorMIYAWAKI, Isabele A.
dc.contributor.authorLOYOLA JUNIOR, Jose Eduardo Riceto
dc.contributor.authorMOREIRA, Vittoria Caporal S.
dc.contributor.authorGOMES, Cintia
dc.contributor.authorSILVA, Caroliny H. A.
dc.contributor.authorOPRYSKO, Carson
dc.contributor.authorNETO, Augusto Barreto do Amaral
dc.contributor.authorCARDOSO, Rhanderson
dc.contributor.authorSAMESIANA, Nelson
dc.contributor.authorPASTORE, Carlos Alberto
dc.contributor.authorTAVARES, Caio A. M.
dc.date.accessioned2024-02-15T15:03:09Z
dc.date.available2024-02-15T15:03:09Z
dc.date.issued2023
dc.description.abstractBackground: Electrocardiographic (ECG) criteria to detect left ventricular hypertrophy (LVH) in patients with left bundle branch block (LBBB) remain under debate. We conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of different ECG criteria for diagnosing LVH in patients with LBBB.Methods: We searched PubMed, Embase, Cochrane, and LILACS for articles evaluating the diagnostic accuracy of ECG criteria for LVH in patients with LBBB published between 1984 and 2023. Echocardiogram, magnetic resonance imaging, or autopsy were used as the reference standard for diagnosis of LVH. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The co-primary outcomes were sensitivity, specificity, the diagnostic odds ratio, and likelihood ratios, estimated using a bivariate generalized linear mixed model for each ECG criterion. The prespecified protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO).Results: We included 12 studies with a total of 1023 patients. We analyzed 10 criteria for LVH on ECG, including the Sokolow-Lyon criterion, the Cornell criterion, the RaVL (R wave in aVL) criterion, the Gubner-Ungerleider criterion, and the Dalfo criterion, among others. The Dalfo criterion was used for 487 patients and had the highest pooled sensitivity of 86% (95% confidence interval [CI] 57%-97%). All the other criteria had poor sensitivities. The Gubner-Ungerleider criterion and the RV5 or RV6 > 25 mm criterion had the highest specificities, with the former being used for 805 patients, obtaining a specificity of 99% (95% CI 80%-100%) and the latter being used for 355 patients, obtaining a specificity of 99% (95% CI 94%-100%). Conclusions: In patients with LBBB, the use of ECG criteria had poor performance for ruling out LVH, mostly due to low sensitivities. None of the criteria analyzed demonstrated a balanced tradeoff between sensitivity and specificity, suggesting that ECG should not be used routinely to screen for LVH.eng
dc.description.indexPubMed
dc.description.indexWoS
dc.description.indexScopus
dc.identifier.citationCJC OPEN, v.5, n.12, p.971-980, 2023
dc.identifier.doi10.1016/j.cjco.2023.08.010
dc.identifier.issn2589-790X
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/58313
dc.language.isoeng
dc.publisherELSEVIEReng
dc.relation.ispartofCjc Open
dc.rightsopenAccesseng
dc.rights.holderCopyright ELSEVIEReng
dc.subject.otherelectrocardiographic diagnosiseng
dc.subject.otherpopulationeng
dc.subject.otherrecommendationseng
dc.subject.otherassociationeng
dc.subject.otherpredictioneng
dc.subject.otherregressioneng
dc.subject.othersocietyeng
dc.subject.wosCardiac & Cardiovascular Systemseng
dc.titleDiagnostic Accuracy of ECG to Detect Left Ventricular Hypertrophy in Patients with Left Bundle Branch Block A Systematic Review and Meta-analysiseng
dc.typearticleeng
dc.type.categoryrevieweng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.affiliation.countryEstados Unidos
hcfmusp.affiliation.countryEspanha
hcfmusp.affiliation.countryisous
hcfmusp.affiliation.countryisoes
hcfmusp.author.externalSOUZA, Isabela A. F. de:Fac Med Petropolis, Petropolis, RJ, Brazil
hcfmusp.author.externalPADRAO, Eduardo M. H.:Harvard Med Sch, Massachusetts Gen Hosp, Dept Pulm & Crit Care, Boston, MA 02115 USA
hcfmusp.author.externalMARQUES, Isabela R.:Univ Int Catalunya, Barcelona, Catalunya, Spain
hcfmusp.author.externalMIYAWAKI, Isabele A.:Univ Fed Parana, Curitiba, Parana, Brazil
hcfmusp.author.externalLOYOLA JUNIOR, Jose Eduardo Riceto:Hosp Alemao Oswaldo Cruz, Sao Paulo, SP, Brazil
hcfmusp.author.externalMOREIRA, Vittoria Caporal S.:Fac Israelita Ciencias Saude Albert Einstein, Sao Paulo, SP, Brazil
hcfmusp.author.externalGOMES, Cintia:Univ Fed Santa Maria, Santa Maria, RS, Brazil
hcfmusp.author.externalSILVA, Caroliny H. A.:Univ Fed Rio Grande do Norte, Natal, RN, Brazil
hcfmusp.author.externalOPRYSKO, Carson:Univ Connecticut, Dept Internal Med, Farmington, CT USA
hcfmusp.author.externalNETO, Augusto Barreto do Amaral:Cent Montana Med Ctr, Lewistown, MT USA
hcfmusp.author.externalCARDOSO, Rhanderson:Harvard Med Sch, Brigham & Womens Hosp, Boston, MA 02115 USA
hcfmusp.citation.scopus0
hcfmusp.contributor.author-fmusphcNELSON SAMESIMA
hcfmusp.contributor.author-fmusphcCARLOS ALBERTO PASTORE
hcfmusp.contributor.author-fmusphcCAIO DE ASSIS MOURA TAVARES
hcfmusp.description.beginpage971
hcfmusp.description.endpage980
hcfmusp.description.issue12
hcfmusp.description.volume5
hcfmusp.origemWOS
hcfmusp.origem.pubmed38204852
hcfmusp.origem.scopus2-s2.0-85178380641
hcfmusp.origem.wosWOS:001149965600001
hcfmusp.publisher.cityAMSTERDAMeng
hcfmusp.publisher.countryNETHERLANDSeng
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