Electrocardiographic (ECG) criteria for determining left ventricular mass in young healthy men; data from the LARGE Heart study.
BACKGROUND
Doubts remain over the use of the ECG in identifying those with increased left ventricular (LV) mass. This is especially so in young individuals, despite their high prevalence of ECG criteria for LV hypertrophy. We performed a study using cardiovascular magnetic resonance (CMR), which provides an in vivo non-invasive gold standard method of measuring LV mass, allowing accurate assessment of electrocardiography as a tool for defining LV hypertrophy in the young.


RESULTS
Standard 12-lead ECGs were obtained from 101 Caucasian male army recruits aged (mean +/- SEM) 19.7 +/- 0.2 years. LV mass was measured using CMR. LV mass indexed to body surface area demonstrated no significant correlation with the Cornell Amplitude criteria or Cornell Product for LV hypertrophy. Moderate correlations were seen with the Sokolow-Lyon Amplitude (0.28) and Sokolow-Lyon Product (0.284). Defining LV hypertrophy as a body surface area indexed left ventricular mass of 93 g/m(2), calculated sensitivities [and specificities] were as follows; 38.7% [74.3%] for the Sokolow-Lyon criteria, 43.4% [61.4%] for the Sokolow-Lyon Product, 19.4% [91.4%] for Cornell Amplitude, and 22.6% [85.7%] for Cornell Product. These values are substantially less than those reported for older age groups.


CONCLUSIONS
ECG criteria for LV hypertrophy may have little value in determining LV mass or the presence of LV hypertrophy in young fit males.
Sohaib
Syed M Afzal
SM
Centre for Cardiovascular Genetics, BHF Laboratories, Royal Free & University College Medical School, London, UK. afzalsohaib@hotmail.com
Payne
John R
JR
Shukla
Rajeev
R
World
Michael
M
Pennell
Dudley J
DJ
Montgomery
Hugh E
HE
D000328:Adult; D004562:Electrocardiography; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D015995:Prevalence; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity; D006113:United Kingdom / Q000453:epidemiology