Evidence map›Paper›PMID 17726091›Full record

SynthesisBMJ (Clinical research ed.)2007

Accuracy of electrocardiography in diagnosis of left ventricular hypertrophy in arterial hypertension: systematic review.

Daniel Pewsner, Peter Jüni, Matthias Egger, Markus Battaglia, Johan Sundström, Lucas M Bachmann

Registry-linked trialAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03542526 (Relationship of Different Electrocardiographic Parameters and Ambulatory Blood Pressure Parameters to Detect Left Ventricular Hypertrophy), which is not on this map. Cited by 115 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
115citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03542526 unknown statusnot on this mapstarted 2019, after this paper: background citation

Relationship of Different Electrocardiographic Parameters and Ambulatory Blood Pressure Parameters to Detect Left Ventricular Hypertrophy

TypeobservationalSponsorAssiut UniversityRan2019 to 2022Enrolled73ConditionsHypertensionArmselectrogradiogram, ambulatory blood prussre
3 · Its place in the literature

Who cites it

115 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Left ventricular hypertrophy in association with cognitive impairment: a systematic review and meta-analysis.Hypertension research : official journal of the Japanese Society of Hypertension · 2017
    Pooled it
  4. Trial
  5. Influence of dietary sodium modulation on electrocardiographic voltage criteria for left ventricular hypertrophy in normotensive individuals.Journal of investigative medicine : the official publication of the American Federation for Clinical Research · 2012
    Trial
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  7. Trial
  8. Article
  9. Observational
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  12. Deep learning to predict left ventricular hypertrophy from the electrocardiogram.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  13. Article
  14. Article
  15. Article
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  17. Article
  18. Article
  19. Article
  20. Review

55 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Daniel PewsnerInstitute of Social and Preventive Medicine (ISPM), University of Bern, Finkenhubelweg 11, CH-3012 Berne, Switzerland.
Peter Jüni
Matthias Egger
Markus Battaglia
Johan Sundström
Lucas M Bachmann

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo review the accuracy of electrocardiography in screening for left ventricular hypertrophy in patients with hypertension.

designSystematic review of studies of test accuracy of six electrocardiographic indexes: the Sokolow-Lyon index, Cornell voltage index, Cornell product index, Gubner index, and Romhilt-Estes scores with thresholds for a positive test of > or =4 points or > or =5 points. DATA SOURCES: Electronic databases ((Pre-)Medline, Embase), reference lists of relevant studies and previous reviews, and experts. STUDY SELECTION: Two reviewers scrutinised abstracts and examined potentially eligible studies. Studies comparing the electrocardiographic index with echocardiography in hypertensive patients and reporting sufficient data were included. DATA EXTRACTION: Data on study populations, echocardiographic criteria, and methodological quality of studies were extracted. DATA SYNTHESIS: Negative likelihood ratios, which indicate to what extent the posterior odds of left ventricular hypertrophy is reduced by a negative test, were calculated.

results21 studies and data on 5608 patients were analysed. The median prevalence of left ventricular hypertrophy was 33% (interquartile range 23-41%) in primary care settings (10 studies) and 65% (37-81%) in secondary care settings (11 studies). The median negative likelihood ratio was similar across electrocardiographic indexes, ranging from 0.85 (range 0.34-1.03) for the Romhilt-Estes score (with threshold > or =4 points) to 0.91 (0.70-1.01) for the Gubner index. Using the Romhilt-Estes score in primary care, a negative electrocardiogram result would reduce the typical pre-test probability from 33% to 31%. In secondary care the typical pre-test probability of 65% would be reduced to 63%.

conclusionElectrocardiographic criteria should not be used to rule out left ventricular hypertrophy in patients with hypertension.

Indexed as

ElectrocardiographyForecastingHumansHypertensionHypertrophy, Left VentricularProfessional PracticeSensitivity and Specificity

Identifiers

PMID17726091
PMCPMC2001078

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.