False-negative electrocardiographic left ventricular hypertrophy in patients with obstructive sleep apnea: Significances of echocardiography and 24-hour blood pressure

Early recognition of left ventricular hypertrophy (LVH) in patients with obstructive sleep apnea (OSA) is an important clinical issue in sleep and cardiovascular medicine. Obesity may influence discrepancies in electrocardiographic and echocardiographic LVH detection in patients with OSA. Electrocardiography (ECG), echocardiography (Echo), and 24-hour ambulatory blood pressure monitoring were performed in 80 consecutive patients with OSA and 32 age-matched controls. Patients with OSA were classified into the following groups: group 1: ECG-LVH(+) and Echo-LVH(+); group 2 (false-negative ECG-LVH): ECG-LVH(-) and Echo-LVH(+); group 3(false-positive ECG-LVH): ECG-LVH(+) and Echo-LVH(-); and group 4: ECG-LVH(-) and Echo-LVH(-).