title: Validity of the ECG diagnosis of left ventricular hypertrophy in normotensive and moderately hypertensive men when using the echocardiographic assessment of left ventricular mass index as reference.
abstract: The diagnostic validity of ECG criteria for left ventricular hypertrophy (LVH) was assessed in 100 men aged 22-64 (mean 47) years with moderate hypertension (Group 1) and 95 age-matched normotensive men (Group 2) using echocardiographic recordings of LV mass index (MI) as reference. A diagnosis of LVH was made in subjects with LVMI greater than or equal to 125 g/m2. Mean LVMI was 126 +/- 34 g/m2 in Group 1 vs. 100 +/- g/m2 in Group 2 (P less than 0.001), and the prevalence of LVH was 48% and 11% respectively (P less than 0.001). The mean ECG voltage according to Sokolow-Lyon (S-L) was 28 +/- 8 mm in Group 1 and 27 +/- 7 mm in Group 2 (NS); with 19% having LVH in Group 1 and 14% in Group 2 (NS). Using the Cornell criterion Group 1 had on average 15 +/- 6 mm vs. 12 +/- 5 mm in Group 2 (P less than 0.001), but only two Group 1 patients had LVH. In Group 2 a significant negative correlation between age and S-L voltage was found (r = 0.33, P less than 0.001). LVMI was not correlated with any of the two voltage criteria using linear regression analysis whereas multiple regression analysis revealed a weak, but significant correlation between LVMI and S-L voltage in Group 1 (t = 2.06, P = 0.04). No subject had LV strain pattern or LVH according to the Romhilt Estes point score system. In the assessment of possible LVH in normal or moderately hypertensive men less than 65-70 years of age, ECG has limited value.
authors.affiliation: Department of Internal Medicine, Vestfold Central Hospital, Toensborg, Norway.
authors.forename: J E
authors.initials: JE
authors.lastname: Otterstad
authors.forename: G
authors.initials: G
authors.lastname: Froeland
authors.forename: A K
authors.initials: AK
authors.lastname: Wasenius
authors.forename: K M
authors.initials: KM
authors.lastname: Knutsen
authors.forename: S
authors.initials: S
authors.lastname: Michelsen
authors.forename: M
authors.initials: M
authors.lastname: Stugaard
mesh_terms: D000328:Adult; D000368:Aged; D006332:Cardiomegaly / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D004452:Echocardiography; D004562:Electrocardiography; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D016276:Ventricular Function; D016277:Ventricular Function, Left / Q000502:physiology