Limitations of the electrocardiographic diagnosis of left ventricular hypertrophy: the influence of left anterior hemiblock and right bundle branch block

Fragola, Pietro V.; Autore, Camillo; Magni, Giuseppina; Albertini, Matteo; Pierangeli, L; Ruscitti, G; Cannata, D

doi:10.1016/0167-5273(92)90080-m

Cited by 16 publications

(13 citation statements)

References 19 publications

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“…In the reports on the LV mass of young adults (19-24-year-old non-athletes), the LV mass ranges from 135 to 197 g in males and from 123 to 128 g in females. [31][32][33][34][35][36][37][38] In the present study, the LV mass in boys (174.4±14.0 g) is almost equal to the results of those previous studies, but in girls the mean value of LV mass (157.4±11.1 g) is somewhat higher than that already presented. Devereux …”

Section: Discussioncontrasting

confidence: 46%

The Relationship Between R Amplitude in Lead V5 (RV5) and Left Ventricular Mass in the Groups of Adolescent Subjects Classified by Body Composition

Sugita

Takada

et al. 1998

Jpn Circ J

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Section: Discussioncontrasting

confidence: 46%

The Relationship Between R Amplitude in Lead V5 (RV5) and Left Ventricular Mass in the Groups of Adolescent Subjects Classified by Body Composition

Sugita

Takada

et al. 1998

Jpn Circ J

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“…As suggested by Hammond et al [31], echocardiographic diagnosis of LVH was based on LVMI [134 g m -2 in men or [110 g m -2 in women. Other methods of diagnosis and cut-off values were proposed [28,32], but those just mentioned have been preferred because largely adopted and validated.…”

Section: Echocardiogrammentioning

confidence: 99%

“…Sensitivity [33] was calculated from two-way tables in relation to the gold standard from the algorithm: sensitivity ð%Þ ¼ ½true positives=ðtrue positives þ false negativesÞ Â 100 and specificity [32] from the algorithm: specificity ð%Þ ¼ ½true negatives=ðtrue negatives þ false positivesÞ Â 100:…”

Section: Reliability Of Ecg Testsmentioning

confidence: 99%

Electrocardiographic criteria of left ventricular hypertrophy in general population

et al. 2008

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The question on whether the electrocardiographic criteria are reliable for detection of left ventricular hypertrophy (LVH) and play a role in predicting outcome is open. Answer can only proceed from population-based studies over unselected people followed up for years. In this study, 1,699 subjects from general population underwent echocardiogram and standard electrocardiogram (ECG) codified for LVH with Minnesota code and with other five methods. Other items were also recorded and used as covariables. Left ventricular mass index (LVMI) was 127.6 +/- 44.9 g m(-2) in men and 120.8 +/- 41.2 g m(-2 )in women, and correlated directly with age in both genders. Prevalence of echocardiographic LVH was 36.6% in men and 53.4% in women. LVMI correlated directly with the Sokolow-Lyon score in both genders at any age, with the Romhilt-Estes, Cornell and R(aVL) scores in all subjects but elderly men, and with the Lewis score in men and women aged < or =69 years. Sensitivity and the predictive value of electrocardiographic tests, as well as the prevalence of LVH diagnosed with electrocardiographic criteria, were always low. Specificity was high for all the tests, and in particular for the Cornell index. Only when diagnosed with echocardiogram or with the Sokolow-Lyon criterion, LVH was an independent predictor of mortality. We conclude that electrocardiographic tests cannot be used as a surrogate of echocardiogram in detecting LVH in the general population because their positive predictive value (PPV) is unacceptably low. On the contrary, they could replace echocardiography in the follow up and for prediction of outcome, when LVH has previously been correctly diagnosed with other methods

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“…R-wave amplitude in leads I and aVL are not reliable criteria for LVH in this situation. Criteria that include the depth of the S wave in left precordial leads improve detection of LVH in the presence of left anterior fascicular block (32)(33)(34).…”

Section: Left Anterior Fascicular Blockmentioning

confidence: 99%

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram

Hancock¹,

Deal²,

Mirvis³

et al. 2009

Journal of the American College of Cardiology

367

141

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Limitations of the electrocardiographic diagnosis of left ventricular hypertrophy: the influence of left anterior hemiblock and right bundle branch block

Cited by 16 publications

References 19 publications

The Relationship Between R Amplitude in Lead V<sub>5</sub> (RV<sub>5</sub>) and Left Ventricular Mass in the Groups of Adolescent Subjects Classified by Body Composition

The Relationship Between R Amplitude in Lead V<sub>5</sub> (RV<sub>5</sub>) and Left Ventricular Mass in the Groups of Adolescent Subjects Classified by Body Composition

Electrocardiographic criteria of left ventricular hypertrophy in general population

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram

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