Standard electrocardiographic criteria for left ventricular hypertrophy demonstrated poor individual sensitivity (14.3%-40.8%) in patients with hypertrophic cardiomyopathy.
Observational (n=49)
No
What is the sensitivity of standard electrocardiographic criteria for left ventricular hypertrophy in patients with hypertrophic cardiomyopathy?
Standard ECG criteria for left ventricular hypertrophy have poor sensitivity in patients with hypertrophic cardiomyopathy, though Cornell Voltage and limb lead criteria correlate positively with left ventricular mass index.
BACKGROUND: Standard 12-lead electrocardiogram (ECG), next to medical history and physical examination, is a basic screening tool for hypertrophic cardiomyopathy in General practice. There are many electrocardiographic criteria of left ventricular hypertrophy, but their accuracy is usually weak in patients with systemic hypertension or aortic stenosis. Sensitivity of these criteria in patients with HCM has not been well described. AIM: To assess the prevalence of electrocardiographic criteria for LVH in patients with HCM and their relationship with echocardiographic parameters. MATERIAL AND METHODS: A total of 49 patients with HCM (mean age 53.2 ± 15.4 years; men/women: 31/18) were enrolled to study. Eight electrocardiographic criteria for LVH were evaluated and correlated with echocardiographic parameters. RESULTS: The ECG features of LVH were found in 36 (73.5%) subjects. These patients had increased thickness of intraventricular septum (20.5 ± 4.7 vs. 17.3 ± 3.2 mm, p = .03), LVM (340.5 ± 104.8 vs. 264.0 ± 61.5 g; p = .02), and LVMI (178.9 ± 48.8 vs. 125.9 ± 22.5; p = .002). All of ECG criteria for LVH had low sensitivity (14.3%-40.8%) for LVH diagnosis confirmed by echocardiography. The most common positive criterion was Cornell Voltage (20 patients; 40.8%). A total of 41 (83.4%) patients had T-wave inversion in limb and/or precordial leads. LVMI correlated positively with R-wave amplitude in aVL (R = 0.34; p = .03), Gubner-Ungerleider voltage (R = 0.4; p = .009), and Cornell Voltage (R = 0.31; p = .04). CONCLUSION: ECG criteria for LVH are characterized by poor sensitivity in patients with HCM. Cornell Voltage and criteria based on limb leads correlate positively with LVMI.
Bula et al. (Tue,) conducted a observational in Hypertrophic cardiomyopathy (n=49). 12-lead electrocardiogram (ECG) vs. Transthoracic echocardiography was evaluated on Prevalence of at least one positive ECG criterion for LVH. Standard electrocardiographic criteria for left ventricular hypertrophy demonstrated poor individual sensitivity (14.3%-40.8%) in patients with hypertrophic cardiomyopathy.