Accuracy of Electrocardiography in Detecting Left Ventricular Hypertrophy in Patients Having Increased Left Ventricular Mass on Echocardiography

Abstract

Objective:  To determine the accuracy of electrocar-diography in diagnosing left ventricular hypertrophy in patients having increased left ventricular mass on echocardiography which is still the most sensitive tool to diagnose left ventricular hypertrophy.

Materials and Methods:  250 male patients, suspec-ted to have LVH on the basis of history (hypertension) and clinical examination, Ejection systolic murmur at aortic area were included in the study. Patients with Acute MI, pericardial effusion, dextrocardia, LBBB pre-excitation syndromes, COPD, Kyphoscoliosis were excluded. Demographic profile were taken from the subject. Presence or absence of LVH was detected on ECG and then positive and negative cases were confirmed on Echocardiography. Data was analysed using SPSS 10.

Results:  Mean age of pts. was 53.01 ± 12.55 years. Forty two patients (16.8%) were diagnosed to have Aortic stenosis and 208 (83.2%) patients had hyper-tension. Majority of the patients 114 (45.6%) had wei-ght between 55 – 69 kg. In 164 patients (65.6%) height of the patients was between 157 – 166 cm. Sensitivity and specificity of ECG was 48.26% and 80% respec-tively, whereas its Accuracy was 50.80%, PPV was 96.52% and NPV was 11.85%. Weight of the patients who were detected as positive LVH cases was ranging between 40 – 54 kg in 27 (24.3%) cases, 55 – 69 in 49 (44.2%) cases and 70 or above in 35 (31.5%) cases. Duration of hypertension was between 1 – 10 years in 70 (77.8%) cases who were detected as LVH positive cases and between 11 – 20 years in 20 (22.2%) cases.

Conclusion:  Electrocardiography cannot be used as the screening tool for the diagnosis of Left Ventricular Hypertrophy.

Key words:  Electrocardiography, Echocardiography, Left Ventricular Hypertrophy. LBBB, MI.