ELECTROCARDIOGRAPHIC AND ECHOCARDIOGRAPHIC EVALUATION OF LEFT VENTRICULAR HYPERTROPHY IN HYPERTENSIVE PATIENTS- A HOSPITAL-BASED STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 10
Abstract
BACKGROUND Left ventricular hypertrophy is associated with increased risk of cardiovascular morbidity and mortality, so its early detection is of major importance for initiation of treatment and its reversal by certain antihypertensive drugs like ARB and ACE inhibitors. The commonly employed technique for detection of LVH are echocardiography and electrocardiography. Although, ECG is a costeffective tool to detect LVH, but its reliability is often questioned when compared to Gold Standard Echocardiography. The aim of the study is to determine the electrocardiographic and echocardiographic findings of LVH in hypertensive patients and to find out the sensitivity of electrocardiography in comparison to echocardiography in determining LVH in these patients. MATERIALS AND METHODS The study is a hospital-based observational study, conducted on 108 Hypertensive patients admitted in Medicine and Geriatrics ward and visited Outpatient Department of Medicine in Gauhati Medical College, Guwahati during the period from August 2016 to July 2017 after considering inclusion and exclusion criteria. Inclusion Criteria- Age more than 12 years with Essential or Secondary Hypertension. Exclusion Criteria- Myocardial ischaemia, cardiomyopathy, valvular heart disease and eccentric hypertrophy and bundle branch block, evidence of MI and arrhythmias on ECG. Clinical and laboratory findings were recorded in preformed proforma. Statistical analysis was performed using Microsoft Excel and GraphPad InStat 3.1 version software. RESULTS The study included a total of 108 Hypertensive patients, out of which 60 (56%) were males and 48 (44%) were females. 82 (75.92%) had LVH by echocardiography and 37 (34.26%) had LVH by electrocardiography. Sensitivity and specificity of ECG in diagnosing LVH is 40.24% and 86.66% respectively in comparison to echocardiography. Sensitivity is highest for Cornell Voltage criteria (40.24%) and lowest for Sokolow-Lyon index criteria (34.14%). CONCLUSION Our study shows that echocardiography is undoubtedly a better instrument for determination of Left Ventricular Hypertrophy. The study also reveals the fact that although ECG is a poor screening tool due to its low sensitivity, but because of its high specificity various factors determining LVH may independently effect determination of LVH.
Authors and Affiliations
Ashok Singh, Bhaskar Baruah, Chitralekha Baruah
Keywords
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- EP ID EP411291
- DOI 10.14260/jemds/2018/272
- Views 47
- Downloads 0
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