Voltage-duration products improved sensitivity for detecting left ventricular hypertrophy at 96% specificity compared to voltage criteria alone (12-lead product 50% vs 43%, p<0.005).
Cross-Sectional (n=389)
Do simple voltage-duration products improve the electrocardiographic detection of echocardiographically determined left ventricular hypertrophy compared to simple voltage criteria alone?
The product of QRS voltage and duration significantly improves the sensitivity of ECG for detecting left ventricular hypertrophy compared to standard voltage criteria alone.
Absolute Event Rate: 50% vs 43%
p-value: p=<0.005
OBJECTIVES: This study was conducted to validate the hypothesis that the product of QRS voltage and duration, as an approximation of the time-voltage area of the QRS complex, can improve the electrocardiographic (ECG) detection of echocardiographically determined left ventricular hypertrophy and to further assess the relative contribution of QRS duration to the ECG detection of hypertrophy. BACKGROUND: The ECG identification of left ventricular hypertrophy has been limited by the poor sensitivity of standard voltage criteria alone. However, increases in left ventricular mass can be more accurately related to increases in the time-voltage area of the QRS complex than to changes in QRS voltage or duration alone. METHODS: Standard 12-lead ECGs and echocardiograms were obtained for 389 patients, including 116 patients with left ventricular hypertrophy. Simple voltage-duration products were calculated by multiplying Cornell voltage by QRS duration (Cornell product) and the 12-lead sum of voltage by QRS duration (12-lead product). RESULTS: In a stepwise logistic regression model that also included Cornell voltage, Sokolow-Lyon voltage, age and gender, QRS duration remained a highly significant predictor of the presence of left ventricular hypertrophy (chi-square 26.9, p 4 (p < 0.001) and the 33% sensitivity of the best-fit logistic regression model in this cohort (p < 0.05 vs. p < 0.001). CONCLUSIONS: QRS duration is an independent ECG predictor of the presence of left ventricular hypertrophy, and the simple product of either Cornell voltage or 12-lead voltage and QRS duration significantly improves identification of left ventricular hypertrophy relative to other ECG criteria that use QRS duration and voltages in linear combinations.
Okin et al. (Wed,) conducted a cross-sectional in Left ventricular hypertrophy (n=389). Voltage-duration products vs. Simple voltage criteria alone was evaluated on Sensitivity for detection of left ventricular hypertrophy at 96% specificity (p=<0.005). Voltage-duration products improved sensitivity for detecting left ventricular hypertrophy at 96% specificity compared to voltage criteria alone (12-lead product 50% vs 43%, p<0.005).