Adding BMI to Electrocardiographic Criteria improves Accuracy of Predicting Left Ventricular Mass in Football Athletes

Abstract

Electrocardiographic (ECG) measurements are commonly used to diagnose left ventricular (LV) hypertrophy in men, yet the validity of this practice has seldom been appraised in American-style football (ASF) athletes. PURPOSE: Evaluate the accuracy of five commonly used ECG criteria for LV hypertrophy – Murphy (AJC, 1984), Sokolow (AHJ, 1949), Gruber (Arch Intern Med, 1943), Cornell (Casale, JACC, 1985), and Cornell voltage-duration product (C-VDP) (Malloy, JACC, 1992) – to predict echocardiographically (ECHO) measured LV mass (LVM) in ASF athletes. METHODS: Resting12-lead ECG and ECHO procedures were performed on 62 collegiate ASF players first entering an NCAA Football Bowl Subdivision university; age=18±1 yr., ht=186±7 cm, wt=99.9±22.6 kg, BMI=28.6±5.0 kg·m2, and BSA=2.23±0.26 m2. Regression was used to predict ECHO-derived LVM and LVM/BSA from the five ECG criteria, and from the ECG criteria with BMI (+BMI) added to the model. RESULTS: Table (*p<0.01 for regression)Table: No title available.None of the ECG criteria alone were predictive of LVM or LVM/BSA in ASF athletes. Adding BMI to the regression significantly improved the predictive accuracy for LVM but not for LVM/BSA. CONCLUSION: ECG criteria alone are not useful in diagnosing LVH in ASF athletes. Our results suggest that adding demographic measures to the predictive model may improve diagnostic accuracy. Thus, new algorithms for evaluating LVM and LVH in ASF athletes should be explored using demographic, body habitus, cardiovascular, and other ECG criteria.