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July 12, 2026European Journal of Pediatrics

A multivariate electrocardiographic predictive model for left ventricular hypertrophy in children with primary hypertension

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Why the study?

Does a nomogram model incorporating BMI and composite ECG indices improve the diagnostic accuracy for LVH in children with primary hypertension?

Population

502 children with primary hypertension (training set n=402, test set n=100)

Comparison

Predictive nomogram model incorporating BMI, RI… vs Conventional adult ECG criteria and previous…

Design

Cohort

Key result

A nomogram model incorporating BMI, RI + SV4, and SD + SV4 accurately detected left ventricular hypertrophy in children with primary hypertension, achieving an AUC of 0.803 in the test set.

Authors

YLYing LiuYCYaxi CuiYLYao Lin

Discussion

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Overview

May aid ECG detection of LVH in hypertensive children; hypothesis-generating and requires prospective validation before use.

Key Points

  • The aim is to create and validate a multivariate ECG model to diagnose left ventricular hypertrophy (LVH) in hypertensive children more effectively.
  • Retrospective study conducted with 502 hypertensive children recruited from January 2019 to December 2024.
  • Cohort split into training set (n=402) and test set (n=100) for model development and validation.
  • 22 ECG parameters were evaluated and a predictive nomogram was created using LASSO and multivariate logistic regression.
  • LVH identified in 29.1% of the training set and 29.0% of the test set, indicating model consistency.
  • The nomogram achieved an area under the curve of 0.822 in the training set and 0.803 in the test set, reflecting strong performance.
  • Model demonstrates good calibration and clinical usefulness, outperforming previous models as confirmed by net reclassification improvement and integrated discrimination improvement.

Study Design

Type

Observational (n=502)

Structured PICO

Does a nomogram model incorporating BMI and composite ECG indices improve the diagnostic accuracy for LVH in children with primary hypertension?

P
Population
502 children with primary hypertension evaluated retrospectively to develop and validate an ECG predictive model for left ventricular hypertrophy.
E
Exposure
Predictive nomogram model incorporating BMI, RI + SV4, and SD + SV4
C
Comparator
Conventional adult ECG criteria and previous models
O
Outcome
Diagnosis of left ventricular hypertrophy (LVH) as defined by echocardiographysurrogate

Main Result

Effect estimate: AUC 0.803

A novel pediatric-specific nomogram integrating BMI and composite ECG indices significantly improves the diagnostic accuracy for left ventricular hypertrophy in children with primary hypertension.

Cite This Study

Liu et al. (2026) conducted an observational in Pediatric primary hypertension (n=502). Nomogram model incorporating BMI, RI + SV4, and SD + SV4 vs. Conventional adult ECG criteria was evaluated on Detection of left ventricular hypertrophy (LVH) (AUC 0.803). A nomogram model incorporating BMI, RI + SV4, and SD + SV4 accurately detected left ventricular hypertrophy in children with primary hypertension, achieving an AUC of 0.803 in the test set.

synapsesocial.com/papers/6a5335444f7abc118adee357https://doi.org/10.1007/s00431-026-07198-6
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