title: Diagnostic accuracy of left ventricular hypertrophy in patients with myocardial infarction by computer-assisted electrocardiography (ELECTROPRES).
abstract: BACKGROUND
  Information is limited about the classification accuracy of electrocardiographic (ECG) criteria for left ventricular hypertrophy (LVH) in the presence of myocardial infarction (MI).
  
  
  METHODS
  We evaluated LVH classification accuracy for a set of 16 ECG criteria and some combinations derived from them in 1642 patients (105 with MI) suspected of coronary heart disease with two-dimensional echocardiography evaluation and a standard 12-lead ECG recorded at the same time. Patients with left bundle branch block had previously been excluded. Measures of classification accuracy included sensitivity, specificity, likelihood ratios, and positive and negative predictive values.
  
  
  RESULTS
  Diagnostic accuracy varied widely for different LVH criteria. The criteria with the best overall performance had highest sensitivity in the presence of MI and sensitivities of approximately 30% with relatively low specificities ranging from 72% to 78%. However, the classification accuracy for them was similar to that for patients without MI. The prevalence of LVH in patients with MI was higher (56%) than in those with no MI (31%). Classification accuracy of the best single previously published LVH criteria was comparable to that of the best combinations of any three of them.
  
  
  CONCLUSIONS
  The classification accuracy of LVH criteria in the presence of MI is comparable to that in patients without MI, in part possibly due to the higher LVH prevalence in the MI group. The presence of a well-validated computer database facilitates comparative evaluation of ECG-LVH criteria and derivation of optimal combinations of criteria for any given clinical application.
authors.affiliation: Cardiac Unit, Hospital Virgen de la Salud, 45005 Toledo, Spain. lrodriguez@sescam.org
authors.forename: Luis
authors.initials: L
authors.lastname: Rodríguez-Padial
authors.forename: Finn
authors.initials: F
authors.lastname: Akerström
authors.forename: Carolina
authors.initials: C
authors.lastname: Robles-Gamboa
authors.forename: Josep
authors.initials: J
authors.lastname: Andrés
authors.forename: Jessica
authors.initials: J
authors.lastname: Ruiz-Baena
mesh_terms: D015331:Cohort Studies; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods / Q000592:standards*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography