P181 COMPARISON OF ECGRAPHIC CRITERIA FOR LEFT VENTRICULAR HYPERTROPHY

Abstract

Abstract The diagnosis of Left ventricular hypertrophy (LVH) in the hypertensive patient is important for the prognosis and therapeutic implications that must be more aggressive in hypertensive with organ damage. On the other hand, echocardiography laboratories (Echo) are overwhelmed by an excessive indiscriminate demand for exams in hypertension. Purpose of Work: In a large population of subjects with high blood pressure we tested some ecgraphic standard criteria for LVH Materials and methods: 12859 ecgs with preoperative cardiological examination have been performed in a cardiological surgery consecutively in the last 3 years. From this population was selected a series of 7615 subjects who had carried out an echocardiogram in the last year ( Echo). Average age 66 23 aa, 61% women and 39% males. The sensitivity ( Se) and specificity (Sp) of several LVH ecgraphic criteria were evaluated in this population: Romhilt–Estes score; Sokolow–Lyon; Cornell, Perugia. Echo reference parameters for LVH were left ventricular mass (LVM) and/or diastolic thickness of interventricular septum (IVS) and posterior wall (PW) of the LV reported in the echo taking into account the reference values for LVH of the last LLGG of the European Society of echocardiography. Results The prevalence of IVS on the ecg for the scores studied was respectively 5.9%, 11.9%, 12.8%, 18.5%. The IVS echo prevalence ranged from 27.8% for LVM > 125 g/m2 to 57.1% for LVM > 51g/m2. Using this last parameter or the thickness of the IVS or PW of the LV the Se and Sp of the various scores / criteria were respectively: 6.9% and 95.9% for Romhilt–Estes; 10.9% and 90.8% for Sokolow–Lyon; 15.9% and 92.1% for Cornell; 23.6% and 84.8% for Perugia. Combining the positivity of at least one of three score/ecgraphic criteria ( Romhilt–Estes, Cornell, Perugia) the SE increased to 35.4% with a slight reduction of the SP of 86.5%. Conclusions The ecg Se for LVH is low with a good Sp; combining multiple scores/ecgraphic criteria of LVH, Se increases without a significant reduction of Sp. The ecg could be used to address the execution of the Echo with a better appropriateness and therefore use of resources .