Validade dos critérios eletrocardiográficos clássicos para diagnóstico de hipertrofia ventricular esquerda em negros Africanos

Abstract

This dissertation, consisting of a scientific article as a product, entitled "Performance of classic electrocardiographic criteria for detection of left ventricular hypertrophy in black Africans" studies electrocardiography as a diagnostic method for Left Ventricular Hypertrophy (LVH), using mass as a gold standard left ventricular determined by means of echocardiography. The main objective is to compare the performance of two of the main electrocardiographic evaluation criteria in the detection of LVH in black adults in Angola. In the article, a review of two main described electrocardiographic criteria, commonly used (Sokolow and Cornell) for the diagnosis of LVH, was performed. We observed a higher electrocardiographic voltage in the two criteria used in participants with LVH detected by echocardiography. The Sokolow criterion showed good results, with the number of positive cases for LVH being higher than for Cornell (31.9% vs 2.1% in men, 8.8% vs 1.9% in women), and the prevalence of LVH detected on echocardiography in women was higher than in men (44.5% vs 37.4%). The specificities and sensitivities of the electrocardiographic criteria, presented in the ROC curve, were small, and the cutoff points suggested in our study are lower than those recommended. Although the LVM determined by the echocardiogram was higher in men than in women (114.2 ± 36.0 vs 98.4 ± 31.9 g/m2, P < 0.05), women had a high prevalence of LVH compared to men (44.5% vs 37.4%; P = 0.085), but without reaching statistical significance. It is concluded that an ideal electrocardiographic criterion that presents high specificity and high sensitivity in different clinical conditions that each patient has in its particularity and the performance of classical electrocardiographic criteria for detection of LVH in African blacks is not well defined. Therefore, for a better capacity of these electrocardiographic criteria in an African population, it is necessary to review the cutoff points.