26. Comparison of Electrocardiographic Criteria for The Diagnosis of Left Ventricular Hypertrophy in Patient with Hypertension

Abstract

Background: Left ventricular hypertrophy (LVH) is an early cardiac complication in patient with hypertension. Several electrocardiographic (EKG) criteria have been identified for the diagnosis of LVH, the criterion that has the most diagnostic value is still unknown at this time. Objective: The objective was to analyse three electrocardiographic criteria for LVH compared with transthoracic echocardiography (TTE) finding. Method: This study was a-single centre, retrospective study, included 55 consecutive patients with hypertension who had visited the cardiology clinic. EKG and TTE were performed. The Peguero Lo-Presti criteria was calculated by adding deepest S amplitude in any precordial lead to the S amplitude in V4 (SD + SV4). Patients with valvular abnormalities, myocardial infarction, LV dysfunction, pericardial disease, bundle branch blocks, atrial fibrillation or flutter, and pulmonary disease were excluded from this study. Results: We found 31 hypertensive patients (56%) had LVH by TTE. Of the 55 patients, 18 patients had LVH based on Peguero Lo-Presti criteria with a sensitivity of 58.06%. Cornell Voltage criteria was positive in 8 out of 55 patients with a sensitivity of 25.81% and Sokolow-Lyon criteria was positive in 6 out of 55 with a sensitivity of 19.35%. The Peguero Lo-Presti EKG criteria had a higher sensitivity (58.06%) and specificity (91.67%) in the diagnosis of LVH than traditional criteria. Conclusion: Peguero Lo-Presti criteria for diagnosing LVH is more sensitive and specific than Sokolow-Lyon and Cornell voltage criteria. Perhaps it is due to the latter component of the QRS complex, which corresponds to the S wave, better represents voltage variations in patients with LVH.