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Pediatric Cardiology

, Volume 39, Issue 7, pp 1378–1388 | Cite as

Comparison of Left Ventricular Hypertrophy by Electrocardiography and Echocardiography in Children Using Analytics Tool

  • Lauren Tague
  • Justin Wiggs
  • Qianxi Li
  • Robert McCarter
  • Elizabeth Sherwin
  • Jacqueline Weinberg
  • Craig Sable
Original Article

Abstract

Left ventricular hypertrophy (LVH) is a common finding on pediatric electrocardiography (ECG) leading to many referrals for echocardiography (echo). This study utilizes a novel analytics tool that combines ECG and echo databases to evaluate ECG as a screening tool for LVH. SQL Server 2012 data warehouse incorporated ECG and echo databases for all patients from a single institution from 2006 to 2016. Customized queries identified patients 0–18 years old with LVH on ECG and an echo performed within 24 h. Using data visualization (Tableau) and analytic (Stata 14) software, ECG and echo findings were compared. Of 437,699 encounters, 4637 met inclusion criteria. ECG had high sensitivity (≥ 90%) but poor specificity (43%), and low positive predictive value (< 20%) for echo abnormalities. ECG performed only 11–22% better than chance (AROC = 0.50). 83% of subjects with LVH on ECG had normal left ventricle (LV) structure and size on echo. African-Americans with LVH were least likely to have an abnormal echo. There was a low correlation between V6R on ECG and echo-derived Z score of left ventricle diastolic diameter (r = 0.14) and LV mass index (r = 0.24). The data analytics client was able to mine a database of ECG and echo reports, comparing LVH by ECG and LV measurements and qualitative findings by echo, identifying an abnormal LV by echo in only 17% of cases with LVH on ECG. This novel tool is useful for rapid data mining for both clinical and research endeavors.

Keywords

Left ventricular hypertrophy Electrocardiography Echocardiography 

Notes

Compliance with Ethical Standards

Conflict of interest

A collaborator contractual agreement has been completed and signed between Philips Healthcare, a division of Philips Electronics North America Corporation, and Children’s National Health System, division of cardiology. There exist no financial interests for the investigator or provider institutions in the outcome of the research.

Research Involving Human and Animal Participants

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of CardiologyChildren’s National Health SystemWashingtonUSA
  2. 2.Philips Research North AmericaCambridgeUSA
  3. 3.Division of Biostatistics and Study MethodsChildren’s National Health SystemWashingtonUSA
  4. 4.Division of CardiologyChildren’s Hospital of Pittsburgh of UPMCPittsburghUSA
  5. 5.Department of CardiologyChildren’s National Health SystemWashingtonUSA

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