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December 6, 2019Journal of Cardiovascular Medicine

Current diagnostic ECG criteria for left ventricular hypertrophy: is it time to change paradigm in the analysis of data?

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Why the study?

Do current ECG criteria accurately diagnose left ventricular hypertrophy compared to transthoracic echocardiography in hospitalized patients?

Population

2134 patients with ECG and echocardiography during the same hospitalization

Comparison

Known ECG criteria for LVH vs transthoracic echocardiography

Design

Retrospective observational study

Key result

Current ECG criteria for left ventricular hypertrophy have low sensitivity, though Cornell voltage and Cornell product demonstrated the most accurate diagnostic performance (AUC 0.678 for Cornell voltage).

Authors

DRDanilo RicciardiGVGiampaolo VettaANAntonio Nenna

Discussion

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Overview

ECG criteria should not replace echocardiography for LVH diagnosis in hospitalized patients; leaves open optimization of Cornell thresholds in prospective studies.

Study Design

Type

Observational (n=2,134)

Structured PICO

Do current ECG criteria accurately diagnose left ventricular hypertrophy compared to transthoracic echocardiography in hospitalized patients?

P
Population
2,134 patients who underwent both ECG and transthoracic echocardiography during the same hospitalization to evaluate diagnostic criteria for left ventricular hypertrophy.
E
Exposure
Various ECG criteria for left ventricular hypertrophy (LVH) including Cornell voltage, RaVF, R5/R6, Q or S aVR, Peguero Lo Presti, and Cornell product
C
Comparator
Transthoracic echocardiography (gold standard)
O
Outcome
Diagnostic performance (sensitivity, specificity, area under the receiver operating characteristic curve) of ECG criteria for LVHsurrogate

Current ECG criteria for LVH have low sensitivity despite acceptable specificity, with Cornell voltage and product offering the most accurate diagnostic performance among them.

Cite This Study

Ricciardi et al. (2019) conducted an observational in Left ventricular hypertrophy (n=2,134). ECG criteria for LVH vs. Transthoracic echocardiography was evaluated on Diagnostic performance (AUC, sensitivity, specificity) of ECG criteria for LVH. Current ECG criteria for left ventricular hypertrophy have low sensitivity, though Cornell voltage and Cornell product demonstrated the most accurate diagnostic performance (AUC 0.678 for Cornell voltage).

synapsesocial.com/papers/6a7db11ac2b228f3e18c9a45https://doi.org/10.2459/jcm.0000000000000907
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