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Influence of serum potassium on the electrocardiographic pattern of left ventricular hypertrophy in primary

M Maciejewska1, B Dabrowska

  • 1Department of Hypertension and Angiology, Academy of Medicine, Warsaw, Poland.

Clinical Cardiology
|October 1, 1992
PubMed

Insights

Hypokalemia, or low potassium, significantly impacts electrocardiogram (ECG) readings for left ventricular hypertrophy (LVH) in primary hyperaldosteronism patients. Low potassium levels can lead to false-positive LVH diagnoses on ECGs.

Area of Science:

  • Cardiology
  • Endocrinology
  • Medical Diagnostics

Background:

  • Left ventricular hypertrophy (LVH) diagnosis via electrocardiogram (ECG) is complex in primary hyperaldosteronism.
  • Factors like hypertension, hypokalemia, and altered renin-angiotensin system activity may influence ECG patterns.

Purpose of the Study:

  • To evaluate ECG signs of LVH in primary hyperaldosteronism patients.
  • To determine the influence of serum potassium, plasma renin activity (PRA), and left ventricular mass on ECG findings.

Main Methods:

  • Retrospective analysis of 55 primary hyperaldosteronism patients.
  • ECG data compared with serum potassium, PRA, and echocardiographically measured left ventricular mass.
  • Multivariate analysis to identify independent predictors of abnormal QRS voltage.

Main Results:

  • An inverse correlation was found between serum potassium and the Sokolow-Lyon index (r = -0.47, p < 0.001).
  • Hypokalemia was prevalent in patients with abnormal QRS voltage but without other LVH indicators (79.2%).
  • Serum potassium concentration was the sole independent predictor of abnormal QRS voltage (p = 0.01).

Conclusions:

  • Hypokalemia is a significant factor affecting QRS complex amplitude in primary hyperaldosteronism.
  • Low potassium levels may lead to misinterpretation of ECGs, resulting in false-positive LVH diagnoses.

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