Comparison of Electrocardiographic Criterias for LVH using Echocardiography as Standard
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 2
Abstract
Introduction: Although newer diagnostic tools are available, the electrocardiogram (ECG) remains the most common mean for evaluating cardiac disease. Electrocardiographic evidence of left ventricular hypertrophy (LVH) is a major marker of cardiovascular morbidity and mortality. Though the specificities of these criteria are typically high (>90%), the sensitivities are lower and in the range of 20-60%. Emerging data suggest that echocardiographically defined LVH is also predictive of cardiovascular disease risk. The present study was designed to compare electrocardiographic criterias for left ventricular hypertrophy, using echocardiography as standard. Material and Methods: The present study was conducted among 100 patients with history and clinical profile suggestive of cardiac morbidities such as essential hypertension, aortic stenosis leading to LVH with evidence of concentric LVH by echocardiographic criteria and/or evidence of LVH by electrocardiographic criteria. Electrocardiographic criteria used in left ventricular hypertrophy were Sokolow-Lyon index, Romhilt and Estes scoring system and total QRS voltage criteria. Diagnostic validity tests (specificity and sensitivity) and Kappa measure of agreement were performed. Results: Using Sokolow-Lyon criteria ECG could diagnose LVH in 26(38%) of patients with 75% specificity. Using Romhilt and Estes scoring system ECG could diagnose LVH in 32 (47%) patients with 75% specificity. Using total QRS criteria ECG could diagnose LVH in 46 (67%) patients with 93% specificity. The present study found sensitivity 38% by Sokolow Lyon index, 47% by Romhilt and Estes point score system and found sensitivity 67% and specificity 93% by total QRS voltage criteria. Conclusion: The sensitivity was in the range of 67% for total QRS voltage criteria to 38% for Sokolow Lyon criteria. Among the different criteria used, Total QRS criteria showed better sensitivity compared to others. In the evaluation of patients for LVH, the role of ECG with all the commonly used criteria is of limited value and ECHO is the method of choice.
Authors and Affiliations
Gurpreet Singh, Anand Gopal Singh Bawa, Savita Kapila, Amarjit Kaur, Saruchi Garg
Keywords
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