PD.01. Accuracy of diagnosing left ventricular hypertrophy with echocardiography and ECG

Background: Traditionally in clinical practice left ventricular hypertrophy (LVH) is diagnosed when the interventricular septal thickness is >12 mm on echocardiography. In addition to echocardiography, electrocardiogram (ECG) is of use in the diagnosis of LVH, and is often utilised as an initial screening tool. The present study aimed to evaluate the reliability of ECG and septal thickness in the diagnosis of LVH Methods: 103 consecutive patients referred to our community cardiology clinic, all diagnosed with LVH due to septal thickness [greater than or equal to] 12 mm on echocardiogram, were retrospectively recruited. The diagnosis of LVH was confirmed only in those who met the American Society of Echocardiography criteria for LVH (LVMI >95g/[m.sup.2] in women and >115g/[m.sup.2] in men). ECGs were assessed for the presence of LVH using the Sokolow-Lyon and Cornell voltage ECG criteria. Results: Of the 103 patients recruited, 94 (91%) were found to have LVH by LVMI on echocardiography. The ECG voltage criteria demonstrated sensitivities of 21% and 20% respectively in diagnosing LVH, and specificities of 89% and 100% respectively. Positive predictive values of the Sokolow-Lyon and Cornell voltage criteria were 95% and 100% respectively. Conclusions: Interventricular septal thickness should not be used as surrogate of LVMI in diagnosing LVH. ECG is insensitive in diagnosing LVH, but demonstrates good specificity and high positive predictive values. Thus, whilst ECG should not be used as a screening tool for LVH, positive results are accurate and can be followed up using echocardiography, hence assessing ECGs for the presence of LVH may detect subclinical cases of LVH where there is little clinical suspicion. doi: 10.1038/jhh.2015.90