Factors associated with diagnostic discrepancy for left ventricular hypertrophy between electrocardiography and echocardiography.
OBJECTIVE
To investigate the influence of cardiovascular risk factors, including fasting plasma glucose (FPG), on the association between electrocardiographic (ECG) and echocardiographic left ventricular hypertrophy (LVH) in an elderly population.


METHODS
We tested cross-sectional associations between electrocardiographic and echocardiographic LVH, defining LVH according to the Sokolow-Lyon voltage combination, Cornell voltage-duration product, or left ventricular mass index (LVMI). Differences between standardized LVMI and Sokolow-Lyon voltage combination or Cornell voltage-duration product (absolute value/cut-off value for LVH) were used as outcome variables in order to identify explanatory variables associated with diagnostic discrepancies between ECG and echocardiography.


RESULTS
Of the 1382 subjects included, 77% did not display any signs of LVH, 6% had LVH defined by ECG only, 13% had LVH defined by echocardiography only, and 5% had LVH on both ECG and echocardiography. Older subjects and those with higher blood pressure and RWT were more likely to have a relatively greater LVMI on echocardiography than that predicted on ECG (odds ratio: 1.65 per 10 years (95% confidence interval (CI): 1.27-2.15), p = .0002, odds ratio: 1.17 per 10 mmHg (95% CI: 1.09-1.25), p < .0001, and odds ratio: 1.21 per 0.10 (95% CI: 1.02-1.42), p = .03). In addition, discrepancy was also seen in females and subjects receiving antihypertensive medication (odds ratio: 1.41 (95% CI: 1.04-1.89), p = .03 and odds ratio: 1.41 (95% CI: 1.06-1.87), p = .02), but FPG did not independently influence discrepancy between ECG and echocardiography.


CONCLUSIONS
Age, blood pressure, female sex, greater RWT and use of antihypertensive medication were associated with a greater risk of non-consistency between LVH determined by ECG and echocardiography.
a Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Cardiovascular and Metabolic Preventive Clinic , Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital , Odense , Denmark.
Søren Sandager
SS
Petersen
a Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Cardiovascular and Metabolic Preventive Clinic , Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital , Odense , Denmark.
Line Reinholdt
LR
Pedersen
a Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Cardiovascular and Metabolic Preventive Clinic , Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital , Odense , Denmark.
Manan
M
Pareek
a Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Cardiovascular and Metabolic Preventive Clinic , Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital , Odense , Denmark.
Mette Lundgren
ML
Nielsen
a Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Cardiovascular and Metabolic Preventive Clinic , Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital , Odense , Denmark.
Søren Zöga
SZ
Diederichsen
b Department of Cardiology , Skåne University Hospital , Malmö , Sweden.
Margrét
M
Leósdóttir
c Department of Clinical Sciences , Lund University, Skåne University Hospital , Malmö , Sweden.
Peter M
PM
Nilsson
d Department of Cardiology , Odense University Hospital , Odense , Denmark.
Axel Cosmus Pyndt
AC
Diederichsen
a Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Cardiovascular and Metabolic Preventive Clinic , Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital , Odense , Denmark.
Michael Hecht
MH
Olsen
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose
Discrepancy; ECG; echocardiography; left ventricular hypertrophy; left ventricular mass