Diagnostic accuracy of electrocardiographic criteria for left ventricular hypertrophy compared with echocardiographic findings

Abstract

Introduction:The electrocardiogram (ECG) is a useful initial tool for detecting left ventricular hypertrophy (LVH), despite its low sensitivity. However, there are no data in the Colombian population on the behavior of the different electrocardiographic criteria. Materials and method: A cross-sectional study was carried out in two specialized cardiology centers in Medellín beginning in 2011, in which the ECGs of 51 patients who met the inclusion criteria were analyzed. Six criteria were calculated, including the Peguero-Lo Presti criterion, while LVH was defined based on two-dimensional and M-mode transthoracic echocardiography. Results: Eighteen patients with electrocardiographic LVH criteria confirmed by echocardiography were analyzed and compared with 33 controls. Left ventricular hypertrophy was found more often in older patients and those with arterial hypertension (HTN) and chronic kidney disease. The ROC curves determined that the best criterion for the electrocardiographic diagnosis of LVH identified by echocardiography is the Peguero-Lo Presti criterion (ROC: 0.81). The specificities of all the criteria were 81-93%, with no significant differences between them. Conclusion: The electrocardiographic criterion with the best diagnostic performance in identifying LVH diagnosed by echocardiography is the Peguero-Lo Presti criterion, compared to the traditional criteria used in the evaluated population.