Electrocardiographic left ventricular hypertrophy has low diagnostic accuracy in middle-aged subjects.
OBJECTIVE
To evaluate the usefulness of electrocardiographic left ventricular hypertrophy (ECG LVH) as a marker of LVH in middle-aged subjects.


METHODS
LVH was determined by cardiovascular magnetic resonance imaging (MRI) in 188 apparently healthy middle-aged [97 men (45+/-7 years) and 91 women (47+/-6 years)]. Receiver operating characteristic (ROC) curves, test sensitivity, specificity, positive and negative predictive values for identifying LVH at different ECG criteria were calculated.


RESULTS
Systolic and diastolic blood pressures were 142+/-13 mmHg and 90+/-8 mmHg in men and 139+/-10 mmHg and 90+/-8 mmHg in women, respectively. LVMI was 78+/-17 g/m2 in men and 67+/-12 g/m2 in women, and 14% of men and 22% of women had LVH in cardiac MRI. Only Sokolow-Lyon and Sokolow-Lyon product had the area under the ROC curve over 0.70. Sokolow-Lyon product had the highest sensitivity (47%). All ECG criteria had high negative predictive values, but the positive predictive values were below 46%.


CONCLUSIONS
Commonly used ECG criteria of LVH have low discrimination ability in middle-aged subjects. ECG LVH alone should not be used as a marker of target organ damage in middle-aged, never treated and apparently healthy hypertensives.
Vottonen
Pasi
P
Department of Internal Medicine, Kuopio University Hospital and University of Kuopio, Kuopio, Finland.
Husso
Minna
M
Sipola
Petri
P
Vanninen
Ritva
R
Peuhkurinen
Keijo
K
Magga
Jarkko
J
D000328:Adult; D001794:Blood Pressure; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity