Key result
ECG criteria show max ~37% sensitivity for detecting echocardiographic LVH in moderate to severe AS.
Why the study?
Aortic valve stenosis induces left ventricular hypertrophy, but the prevalence and diagnostic correlation of ECG criteria for LVH with echocardiographic parameters in these patients needed assessment.
Do electrocardiographic criteria for LVH accurately identify LVH and correlate with echocardiographic parameters in patients with moderate to severe aortic valve stenosis?
Observational (n=95)
Do electrocardiographic criteria for LVH accurately identify LVH and correlate with echocardiographic parameters in patients with moderate to severe aortic valve stenosis?
Standard ECG criteria for LVH have poor sensitivity and correlate weakly with echocardiographic indices of LVH and disease severity in patients with moderate to severe aortic stenosis.
Answers are grounded in this paper and cite their sources.
ECG criteria miss most LVH cases in aortic stenosis; leaves open whether refined thresholds or alternatives improve detection.
BACKGROUND: Aortic valve stenosis (AS) generates a chronic pressure overload that induces left ventricular hypertrophy (LVH). The aim of this study was to assess the prevalence of the electrocardiographic criteria for LVH in patients with clinically significant AS and to evaluate the relationship between the ECG criteria for LVH and echocardiographic parameters. METHODS: The clinical data of 95 patients with moderate to severe AS were retrospectively analyzed. Eight ECG criteria for LVH were used and compared to the results of transthoracic echocardiography (TTE). The ECG parameters had a low sensitivity (6%-36.9%) with a specificity of up to 100%. The Cornell Voltage criteria had the best sensitivity with a specificity of 63.6% and the highest correlation with the LVMI (r = 0.38, p < 0.001). All of the ECG parameters correlated positively with the peak aortic jet velocity as well as with the mean aortic gradient. CONCLUSION: The electrocardiographic criteria for LVH in patients with moderate or severe AS have a poor sensitivity in identifying LVH confirmed by TTE. The values of the selected ECG criteria for LVH correlate weakly with both the TTE indices of LVH and the markers of AS severity.
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Bula et al. (2019) conducted an observational in Moderate to severe aortic valve stenosis (AS) (n=95). Electrocardiographic (ECG) criteria for LVH vs. Transthoracic echocardiography (TTE) was evaluated on Correlation between ECG criteria for LVH and echocardiographic parameters (LVMI) (r = 0.38, p=< 0.001). Electrocardiographic criteria for LVH in patients with moderate to severe aortic stenosis demonstrated poor sensitivity (6%-36.9%) for identifying LVH confirmed by echocardiography.
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