ECG voltage criteria for left ventricular hypertrophy showed limited diagnostic accuracy in hypertrophic cardiomyopathy (maximum 58% for Amplitude total) and poor correlation with cardiac MRI.
Case-Control (n=133)
Do standard ECG voltage criteria accurately diagnose left ventricular hypertrophy in patients with hypertrophic cardiomyopathy compared to cardiac MRI?
Standard ECG voltage criteria for left ventricular hypertrophy have poor diagnostic accuracy and correlate poorly with MRI-derived left ventricular mass in patients with hypertrophic cardiomyopathy.
BACKGROUND: Several ECG voltage criteria have been proposed for the diagnosis of left ventricular hypertrophy (LVH). Notably, ECG criteria have been historically validated in concentric LVH but not in hypertrophic cardiomyopathy (HCM), wherein the hypertrophy pattern is typically asymmetric. OBJECTIVES: The aim of our study was to evaluate the performance of ECG voltage criteria for LVH diagnosis in the HCM population. MATERIAL AND METHODS: The electrocardiograms of 92 HCM patients and 41 sex- and age-matched controls were evaluated with the most frequently used ECG voltage criteria for LVH diagnosis. Cardiac magnetic resonance (MRI) was performed in HCM and controls in order to quantify LVH and its distribution. RESULTS: In the HCM population, the maximal diagnostic accuracy was achieved by Amplitude total and Amplitude total product criteria (58% for both), while the Cornell Voltage best performed in septal HCM (62%), the Sokolov in aVL and Gubner criteria in apical HCM (79% for both) and the Cornell Voltage and Product in anterior HCM (86% for both). All the ECG voltage criteria showed a poor correlation with left ventricular mass and maximal thickness measured by cardiac MRI. CONCLUSIONS: In our study, only a few ECG voltage criteria used for the detection of LVH in clinical practice showed an acceptable performance in the HCM population. Further studies are needed to clarify the role of ECG for LVH detection in HCM patients.
Monzo et al. (Mon,) conducted a case-control in Hypertrophic cardiomyopathy (n=133). ECG voltage criteria vs. Cardiac magnetic resonance (MRI) was evaluated on Diagnostic accuracy of ECG voltage criteria for LVH diagnosis. ECG voltage criteria for left ventricular hypertrophy showed limited diagnostic accuracy in hypertrophic cardiomyopathy (maximum 58% for Amplitude total) and poor correlation with cardiac MRI.