A newly derived 5-criteria ECG scoring system for detecting left ventricular hypertrophy achieved 62.5% sensitivity and 83.2% specificity at a 1.5-point threshold in an independent validation cohort.
Cohort (n=6,396)
Does a newly derived 5-criteria ECG scoring system improve the diagnostic accuracy of left ventricular hypertrophy compared to conventional criteria in outpatients?
A novel 5-criteria ECG scoring system improves sensitivity for detecting left ventricular hypertrophy compared to conventional criteria, with only a modest decrease in specificity.
BACKGROUND: Left ventricular hypertrophy (LVH) is a common manifestation of cardiovascular disease and a risk factor for cardiovascular morbidity and mortality, but available methods for its electrocardiographic (ECG) diagnosis have limited accuracy. AIM: To investigate findings associated with LVH on ECG and developed an improved system for the diagnosis of LVH. METHODS: A cohort study comparing ECG data acquired within 30 days of transthoracic echocardiography (TTE) was performed. Multivariate regression analysis identified ECG findings associated with increased LV mass and mass index. A scoring system was derived and performance compared to established criteria for LVH. RESULTS: Data from 5486 outpatients with TTEs and corresponding ECGs were included in the derivation cohort, 333 (6.1%) of whom had LVH by TTE. In the primary regression analysis, findings associated with LVH were amplitudes of Q in V3, R in V6, S in V3, T in V6, P' in V1, P in V6, as well as R and T-axis discordance, R peak time in V6, QRS duration, weight, height, sex, and age. From this we derived a score consisting of 5 criteria, and validated it in an independent cohort of 910 patients. With a threshold of 1.5 points, sensitivity and specificity were 67.9% and 81.4%, and 62.5% and 83.2% in the derivation and validation cohorts, respectively. With a threshold of 2 points, sensitivity and specificity were 42.3% and 93.0%, and 37.5% and 93.4% in these cohorts. CONCLUSIONS: This score had superior sensitivity for detection of LVH by ECG while making a modest sacrifice in specificity compared to conventional criteria.
Braunstein et al. (Thu,) conducted a cohort in Left ventricular hypertrophy (LVH) (n=6,396). New 5-criteria ECG scoring system vs. Established criteria for LVH was evaluated on Detection of LVH by ECG. A newly derived 5-criteria ECG scoring system for detecting left ventricular hypertrophy achieved 62.5% sensitivity and 83.2% specificity at a 1.5-point threshold in an independent validation cohort.
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