Effect of Smoking on Electrocardiographic Criteria of Left Ventricular Hypertrophy in Hypertensive Patients

Abstract

This study was undertaken to evaluate the influence of cigarette smoking on diagnostic accuracy of ECG for diagnosis of LVH, and also to assess the effect of cigarette smoking on LV structure and functions. The present study included 60 newly-discovered hypertensive male patients of the same age, systolic BP, diastolic BP, BSA (m2), and the same BMI (kg/m2). According to the smoking habit patients were classified into 2 groups:- Group (I): Smokers known by self-reported consumption of more than (15) cigarettes per-day (number = 25) and Group (II); non-smokers (number = 35). All subjects were submitted to the following: 1) Full history including history of cigarette smoking. 2) Full clinical examination. 3) Measurement of the height and weight to calculate, BSA and BMI. 4) Standard 12-lead electrocardiogram. 5) Echocardiographic examination of the following: • LVEDD. • LVESD. «IVST at end-diastole. ® PwT at end-diastole. • LA diameter. ® Aortic root diameter, o PVE • PVA «E/A ratio Assessment of LV systolic function by calculation of: • FS %. • EF%. Systolic dysfunction in this study was defined when EF% < 50%. Assessment of LV diastolic dysfunction: Diastolic dysfunction is defined if E/A ratio < 1. Calculation of LVM and LVMI Using penn convention, in male LVM is 135 g and LVMI 71 g/m2 LVH defined as a LV mass index >131 g/m2. The exclusion criteria were the following: 1- Patients previously treated for hypertension. 2- Patients defined from history, clinical examination, electro¬cardiography, or echocardiography to have myocardial ischemia, old myocardial infarction, cardiomyophy, valvular heart diseases, cardiac arrhythmia, left bundle branch block, wolff-parkinson-white syndrome, digitalis treatment, and electrolyte disturbance. 3- Patients with diabetes mellitus. 4- Patients who technically had poor echocardiographic window. Sensitivity and Specificity of ECG in diagnosis of LVH in the studv group: The present study showed that sensitivity of ECG is affected by smoking status as sensitivity of different ECG criteria is lower in smokers group compared to non-smokers. Even the most sensitive criterian