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January 1, 2013Journal of the Korean Society of HypertensionOpen Access

Electrocardiogram criteria for detecting left ventricular hypertrophy in a Korean general population showed low sensitivity (2.8-14.3%) and high specificity (93.6-98.7%), with suboptimal AUCs (0.52-0.60), limiting their usefulness as a mass screening tool.

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Why the study?

What is the diagnostic accuracy of ECG criteria (Sokolow-Lyon and Cornell) for detecting left ventricular hypertrophy compared to echocardiography in a Korean general population?

Population

1,946 adults from a community-based cohort in Korea

Comparison

Electrocardiogram criteria for left ventricular… vs Echocardiographic measurement of left…

Design

Cohort

Key result

Electrocardiogram criteria for detecting left ventricular hypertrophy in a Korean general population showed low sensitivity (2.8-14.3%) and high specificity (93.6-98.7%), with suboptimal AUCs (0.52-0.60), limiting their usefulness as a mass screening tool.

Authors

MAMin‐Soo AhnBYByung‐Su YooJLJi Hyun Lee

Discussion

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Overview

ECG criteria lack screening utility in Korean adults; leaves open whether ethnicity-specific thresholds improve detection.

Key Points

  • To assess the diagnostic accuracy of standard electrocardiogram (ECG) criteria for detecting left ventricular hypertrophy (LVH) compared to echocardiography in a general population cohort.
  • Analyzed N=1,946 adults from a rural Korean community-based cohort who underwent both echocardiography and standard 12-lead ECG.
  • Calculated left ventricular mass index (LVMI) normalized to body surface area, defining LVH as values at or above the sex-specific 90th percentile (≥120.8 g/m² in males and ≥112.2 g/m² in females).
  • Evaluated the diagnostic sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) for Sokolow-Lyon and Cornell voltage criteria.
  • LVMI was significantly higher in males than in females (91.1 ± 23.9 g/m² vs. 83.9 ± 21.7 g/m², p < 0.001).
  • Sokolow-Lyon criteria demonstrated a sensitivity of 5.6% and specificity of 93.6% in males (AUROC 0.55), and a sensitivity of 4.1% and specificity of 97.8% in females (AUROC 0.59).
  • Cornell criteria demonstrated a sensitivity of 2.8% and specificity of 98.7% in males (AUROC 0.52), and a sensitivity of 14.3% and specificity of 95.8% in females (AUROC 0.60).

Study Design

Type

Cross-Sectional (n=1,956)

Multicenter

No

Structured PICO

What is the diagnostic accuracy of ECG criteria (Sokolow-Lyon and Cornell) for detecting left ventricular hypertrophy compared to echocardiography in a Korean general population?

P
Population
1,956 adults from a rural Korean community cohort who underwent both echocardiography and electrocardiography to evaluate the diagnostic accuracy of ECG for left ventricular hypertrophy.
E
Exposure
Electrocardiogram (ECG) criteria for left ventricular hypertrophy (Sokolow-Lyon and Cornell criteria)
C
Comparator
Echocardiographic measurement of left ventricular mass index (LVMI) adjusted with body surface area (LVH defined as ≥ sex-specific 90th percentile)
O
Outcome
Diagnostic accuracy (sensitivity, specificity, and area under the receiver operating characteristic curve) for detection of LVHsurrogate

ECG criteria for left ventricular hypertrophy have low sensitivity and suboptimal performance in the general Korean population, limiting their usefulness as a mass screening tool.

Limitations

  • The study was conducted in a single rural area, which may limit generalizability to the entire Korean population.
  • Reference values for left ventricular mass index were based on Western guidelines, although adjusted to the 90th percentile of this specific cohort.

Cite This Study

Ahn et al. (2013) conducted a cross-sectional in Left ventricular hypertrophy (n=1,956). Electrocardiogram criteria (Sokolow-Lyon and Cornell) vs. Echocardiography (Left ventricular mass index) was evaluated on Diagnostic accuracy (sensitivity, specificity, and area under the curve) of ECG criteria for detecting left ventricular hypertrophy. Electrocardiogram criteria for detecting left ventricular hypertrophy in a Korean general population showed low sensitivity (2.8-14.3%) and high specificity (93.6-98.7%), with suboptimal AUCs (0.52-0.60), limiting their usefulness as a mass screening tool.

synapsesocial.com/papers/6a992bfee739824d2c78ce76https://doi.org/10.5646/jksh.2013.19.4.112
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Also Consider

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