Electrocardiographic left ventricular hypertrophy has low diagnostic accuracy in middle-aged subjects

Abstract

Objective. To evaluate the usefulness of electrocardiographic left ventricular hypertrophy (ECG LVH) as a marker of LVH in middle-aged subjects. Methods. LVH was determined by cardiovascular magnetic resonance imaging (MRI) in 188 apparently healthy middle-aged [97 men (45 ± 7 years) and 91 women (47 ± 6 years)]. Receiver operating characteristic (ROC) curves, test sensitivity, specificity, positive and negative predictive values for identifying LVH at different ECG criteria were calculated. Results. Systolic and diastolic blood pressures were 142 ± 13 mmHg and 90 ± 8 mmHg in men and 139 ± 10 mmHg and 90 ± 8 mmHg in women, respectively. LVMI was 78 ± 17 g/m2 in men and 67 ± 12 g/m2 in women, and 14% of men and 22% of women had LVH in cardiac MRI. Only Sokolow-Lyon and Sokolow-Lyon product had the area under the ROC curve over 0.70. Sokolow-Lyon product had the highest sensitivity (47%). All ECG criteria had high negative predictive values, but the positive predictive values were below 46%. Conclusions. Commonly used ECG criteria of LVH have low discrimination ability in middle-aged subjects. ECG LVH alone should not be used as a marker of target organ damage in middle-aged, never treated and apparently healthy hypertensives.