Prediction of Left Ventricular Mass Index Using Electrocardiography in Essential Hypertension – A Multiple Linear Regression Model

Background: Current electrocardiography (ECG) criteria indicate only the presence or absence of left ventricular hypertrophy (LVH). LVH is a continuum and a direct relationship exists between left ventricular mass (LVM) and cardiovascular event rate. We developed a mathematical model predictive of LVM index (LVMI) using ECG and non-ECG variables by correlating them with echocardiography determined LVMI. Patients and Methods: The model was developed in a cohort of patients on treatment for essential hypertension (BP> 140/90 mm of Hg) who underwent concurrent ECG and echocardiography. One hundred and forty-seven subjects were included in the study (56.38± 11.84 years, 66% males). LVMI was determined by echocardiography (113.76± 33.06 gm/m 2 ). A set of ECG and non-ECG variables were correlated with LVMI for inclusion in the multiple linear regression model. The model was checked for multicollinearity, normality and homogeneity of variances. Results: The final regression equation formulated with the help of unstandardized coefficients and constant was LVMI =18.494+ 1.704 ( aLL ) + 0.969 ( RaVL+SV3 ) + 0.295 ( MBP ) + 15.406 ( IHD ) (aLL – sum of deflections in augmented limb leads; RaVL+SV3 – sum of deflection of (R wave in aVL + S wave in V3); MBP – mean blood pressure; IHD=1 for the presence of the disease, IHD=0 for the absence of the disease). Conclusion: In the model, 50.4% of the variability in LV mass is explained by the variables used. The findings warrant further studies for the development of better and validated models that can be incorporated in microprocessor-based ECG devices. The determination of LVMI with ECG only will be a cost-effective and readily accessible tool in patient care.