Do common ECG voltage criteria accurately detect left ventricular hypertrophy in young adults compared to echocardiography?
Common ECG voltage criteria have low sensitivity for detecting left ventricular hypertrophy in young adults, precluding their use as effective screening tests.
AIM: To investigate validity of electrocardiographic (ECG) criteria for left ventricular hypertrophy (LVH) in young adults. METHODS: Retrospectively, echocardiograms showing LVH and concomitant electrocardiograms were collected in patients 18 to 39 years old. A control group of patients without LVH was collected. Using echocardiogram as the gold standard, electrocardiograms were analyzed using common voltage criteria. RESULTS: Study included 100 subjects (52% male, mean age = 28 ± 6.8 years, 96% Hispanic or African-American) with 50% LVH prevalence. Sensitivity and specificity for Sokolow-Lyon criteria were 24% (95%CI: 13.5%-38.4%) and 88% (95%CI: 74.9%-95%). For Cornell criteria, sensitivity was 32% (95%CI: 19.9%-46.8%) and specificity 98% (95%CI: 87.9%-99.8%). For R in aVL criteria, sensitivity was 12% (95%CI: 4.9%-25%) and specificity 100% (95%CI: 91.1%-100%). CONCLUSION: In young adults common ECG voltage criteria have low sensitivities and high specificities similar to other age groups. Low sensitivities preclude these ECG criteria from serving as effective screening tests.
Sklyar et al. (Sun,) studied this question.