Prediction of Left Ventricular Echocardiography Mass from Romhilt-Estes score in hypertensive patients in Kinshasa: Cross-sectional study

Abstract

Abstract Introduction : Transthoracic Doppler echocardiography (TDE) is an essential tool in the diagnosis of left ventricular hypertrophy (LVH), alongside the Gold standard which is magnetic resonance imaging (MRI), which is much more expensive. TDE is an easily accessible tool in developed countries but remains difficult to access in most rural areas of sub-Saharan African countries, making the diagnosis of LVH difficult. However, it is a predictive factor of cardiovascular events in hypertensive patients. The electrocardiogram being more accessible in these environments, we evaluated its performance in the diagnosis of LVH and especially sought to predict left ventricular mass from the most sensitive and specific electrocardiographic score in our study, the Romhilt-Estes. Method This is an analytical study of a consecutive series of cases, which covered the period from July to September 2018, in five hospital facilities in Kinshasa. Socio-demographic parameters, ECG, and TDE were studied. Spearman's Rho correlation coefficient and Bland Altman concordance test were used for numerical values. And multiple linear regression modeling was used for the entire workforce and in each sex separately. Results The area below the ROC curve of the Romhilt-Estes score was significantly greater than that of the other ECG indices (X²=4.78; p = 0.0289); the most important correlation coefficient was observed between the MVG and the Romhilt-Estes score (0.436) with better alignment and dispersion (95% CI) and finally in the multiple linear regression, age and the score of Romhilt-Estes emerged in both sexes as independent determinants of LVM. Conclusion Age and sex are variables that influence the modeling of LVM based on the Romhilt-Estes score. But the mathematical models found have a weak prediction.