Age-Related Differences in the Diagnostic Yield of Surface Electrocardiography Defined Voltage and Parameters in Identifying Left Ventricular Hypertrophy and Estimated Cardiovascular Risks

Abstract

Surface electrocardiography (ECG) for assessing the estimated risk for future coronary heart diseases in the asymptomatic population has not been fully explored. Furthermore, information regarding age-related differences in such a clinical issue is lacking. We evaluated the diagnostic performance of several combinations of voltage criteria obtained from electrocardiography by comparison to echocardiography performed on 379 individuals without preexisting cardiovascular diseases and determined the association of these criteria with the Framingham risk (FRS) and the adult treatment panel (ATP) scores from the National Cholesterol Education Program. The ECG parameters were significantly correlated with the participants' age. Among participants < 65 years of age, several criteria (including the Sokolow-Lyon score, Cornell voltage, Cornell product, McPhie score and Gubner & Ungerleider criteria) were positively associated with FRS by multivariate analysis, while Cornell voltage, Cornell product, Gubner & Ungerleider criterion and QRS duration were significantly associated with the ATP score. Few ECG criteria were associated with both cardiovascular risk scores above 65 years of age. However, gender-adjusted McPhie and Gubner & Ungerleider criterion were observed to be powerful predictors of left ventricular hypertrophy (LVH) in subjects less than 65 years old, as determined by echocardiography. Electrical alterations, as determined by various parameters from surface ECG, correlate with age and estimated cardiovascular risk factors, while McPhie and Gubner & Ungerleider criteria help identify structural changes in terms of LVH in subjects of a relatively younger age.