Citation Information :
Kaur R, Kamra A, Aggarwal A. A Comparative Study of Electrocardiographic and Echocardiographic Evidence of Left ventricular Hypertrophy. Curr Trends Diagn Treat 2017; 1 (2):59-63.
Introduction: The increased risk of morbidity and mortality associated with left ventricular hypertrophy (LVH) diagnosed by electrocardiogram (ECG) or echocardiography is well known. The aim of the study was to evaluate ECG and echocardiography evidence of LVH in patients provisionally diagnosed to have LVH on clinical assessment and to determine the sensitivity and specificity of different criteria of LVH on ECG in comparison with echocardiography.
Materials and methods: Hundred patients provisionally diagnosed to have LVH based on clinical assessment were enrolled in this study. A standard 12-lead ECG was recorded. Left ventricular hypertrophy was measured on ECG by applying following criteria: Sokolow–Lyon, Cornell, Romhilt–Estes score. Using two-dimensional echocardiography as the gold standard, LVH was calculated. Sensitivity and specificity of different criteria of ECG were calculated in comparison with echocardiography.
Results: Out of 100 patients suspected to have LVH, 91 patients were found to have LVH on echocardiography. Indicating that echocardiography has sensitivity of 91% and diagnostic accuracy of 91%. On comparing different criteria, Sokolow criterion was found to have maximum sensitivity of 38.46%, while Cornell criterion was least sensitive, i.e., 14.29%, and sensitivity of Romhilt–Estes criterion was 19.78%. However, overall sensitivity of ECG can be increased by combining all the criteria, i.e., to 45.05%. Specificity of different criteria of ECG was high, i.e., as much as 100% in case of Romhilt–Estes criterion, while overall specificity of ECG was 77.778%.
Conclusion: Sensitivity and diagnostic accuracy of ECG were very low in comparison with echocardiography in detecting LVH; therefore, ECG cannot replace echocardiography in detecting LVH. Overall sensitivity of different criteria of ECG was low. However, sensitivity of ECG can be increased by combining Sokolow-Lyons voltage criteria and Cornell voltage criteria with Romhilt–Estes point score.
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