An analysis of electrocardiographic criteria for determining left ventricular hypertrophy.
OBJECTIVE
To determine the most sensitive criterion for the detection of left ventricular hypertrophy according to echocardiographically defined left ventricular mass.


METHODS
The Sokolow-Lyon voltage, Sokolow-Lyon-Rappaport, Cornell voltage duration product, White-Bock, and Romhilt-Estes point scoring criteria were compared with left ventricular mass index, corrected for body surface, obtained from the echocardiograms of 306 outpatients (176 females, 130 males), of all age groups.


RESULTS
The Cornell voltage duration product criteria index had the greatest sensitivity in women (54.90%), and the Sokolow-Lyon-Rappaport index was most sensitive in men (73.53%). When applied to men at the same voltage amplitude (20mm) as that in women, the Cornell index showed increased sensitivity relative to the conventional index (28mm) of 67.65% (P</=0.01) and a sensitivity similar to that of the Sokolow-Lyon-Rappaport index, with higher specificity (P</=0.01). The White-Bock and Romhilt-Estes criteria were the least sensitive in men and women, despite their high specificity. The electrocardiographic criteria were more efficient when dilatation predominated over left ventricular hypertrophy.


CONCLUSIONS
The Cornell index had greater sensitivity in women, and the Sokolow-Lyon-Rappaport index was more sensitive in men. When applied to men at the same voltage amplitude as that of women, the Cornell index had an increase in sensitivity similar to that of the Sokolow-Lyon-Rappaport index.
Gasperin
Carlos Alberto
CA
Hospital de Clínicas de Curitiba, Universidade Federal do Paraná, Curitiba, PR, Brazil. gasperin@cardiol.br
Germiniani
Helio
H
Facin
Carlos Roberto
CR
Souza
Admar Moraes de
AM
Cunha
Cláudio Leinig Pereira da
CL
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D017678:Sex Distribution