title: Electrocardiographic prediction of left ventricular geometric patterns in patients with essential hypertension.
abstract: BACKGROUND
  The present study sought to determine the diagnostic value of electrocardiographic voltage criteria in predicting geometry patterns in patients with essential hypertension.
  
  
  METHODS
  Patients with essential hypertension (n=125) according to left ventricular mass index and relative wall thickness as determined by echocardiography were assigned in the following groups: normal geometry (N, n=50), concentric remodeling (CR, n=12), concentric hypertrophy (CH, n=28) and eccentric hypertrophy (EH, n=35). Each patient underwent 12-lead ECG followed by determination of conventional voltage criteria as well as peak to peak QRS lengths in each lead.
  
  
  RESULTS
  Voltage criteria such as Sokolow-Lyon, Cornell, Cornell product >2440, D1R+D3S >25 mm, and AVL R >11 mm could not significantly predict and discriminate geometric patterns of LVH. However, they all were very specific (range 97-100%) and showed very high positive predictive values (range 94-100%) for detecting abnormal geometry. DI peak >12 mm had a sensitivity 61%, specificity 67%, accuracy 63%, positive predictive value 81%, and negative predictive value 42% in predicting to differentiate CH from CR. Sum of the calculated values from the peak of the R to the nadir of the S wave in all limb leads >60 mm had sensitivity 68%, specificity 75%, accuracy 70%, positive predictive value 86% and negative predictive value 50% in predicting to differentiate CH from CR.
  
  
  CONCLUSIONS
  Conventional ECG voltage criteria could not significantly discriminate specific geometry patterns observed in patients with essential hypertension.
authors.affiliation: Department of Cardiology, School of Medicine, Trakya University, Edirne, Turkey.
authors.forename: Meryem
authors.initials: M
authors.lastname: Aktoz
authors.forename: Okan
authors.initials: O
authors.lastname: Erdogan
authors.forename: Armagan
authors.initials: A
authors.lastname: Altun
mesh_terms: D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*; D020257:Ventricular Remodeling / Q000502:physiology*