Abstract:
The objective of the study was to assess the relative contributions and benefits of chest radiogram and electrocardiogram in detecting left ventricular hypertrophy among adult hypertensives. Seventy consecutive, newly diagnosed hypertensive patients with forty age and sex comparable healthy controls were recruited for the study at the University of Maiduguri Teaching Hospital, Northeast, Nigeria. The echocardiographic mean Left Ventricular Mass (LVM) was 260.8 ± 72.9 g (range 109.8 to 429.8 g) and 136.9 ± 18.1 g (range 104 to 188.9 g) in patients and controls respectively (p<0.001). Echocardiographic LVM correlated fairly with Cardiothoracic Ratio (CTR) on chest X-ray (r = 0.43, p<0.01) followed by SV 2 + RV6 with a correlation of 0.39 (p<0.01). However, in terms of sensitivity, specificity and accuracy in comparison with ECHO LVM, SV2 + RV6 had better indices than CTR. The sensitivity, specificity and accuracy indices were 0.60, 0.93 and 0.67 for SV2 + RV6 as compared to 0.53, 0.87 and 0.60 for CTR, respectively. Though previous studies had noted echocardiography as the gold standard in this form of assessment, however most centres in the developing world lacked facility for this purpose. In contrast radiography and electrocardiography are uniformly available. In view of the results, we recommend that chest X-ray and electrocardiograms might be simple screening procedures in the management of hypertensive heart disease where echocardiography is inaccessible.