The strain pattern, and not Sokolow-Lyon electrocardiographic voltage criteria, is independently associated with...

Area of Science:

• Cardiology
• Medical Imaging
• Diagnostic Electrocardiography

Background:

• Obesity and chest-wall thickness can affect electrocardiographic (ECG) criteria for left ventricular hypertrophy (LVH).
• Previous studies often did not account for these confounding factors when assessing ECG-LVH relationships.
• Multislice computed tomography (MSCT) allows comprehensive assessment of cardiac structure and chest-wall dimensions.

Purpose of the Study:

• To evaluate the relationship between ECG voltage criteria (Sokolow-Lyon) and strain patterns with anatomic left ventricular hypertrophy (LVH).
• To determine the influence of factors like obesity and chest-wall thickness on these ECG-LVH correlations using MSCT.
• To compare the diagnostic performance of ECG criteria against MSCT-derived LVH measurements.

Main Methods:

• Ninety-three patients undergoing MSCT angiography were included.
• Anatomic LVH was defined by increased left ventricular mass measured via MSCT.
• Sokolow-Lyon voltage and strain patterns were assessed and correlated with MSCT findings.

Main Results:

• The Sokolow-Lyon voltage criteria showed lower sensitivity (57%) and specificity (67%) for detecting anatomic LVH.
• The ECG strain pattern demonstrated higher sensitivity (65%) and specificity (87%) for anatomic LVH.
• Multivariate analysis confirmed that the strain pattern, but not Sokolow-Lyon voltage, remained significantly associated with anatomic LVH after adjusting for confounding factors.

Conclusions:

• The ECG strain pattern is a more reliable indicator of anatomic LVH than the Sokolow-Lyon voltage criteria, even when accounting for obesity and chest-wall thickness.
• MSCT provides valuable data for refining the interpretation of ECG findings in LVH assessment.
• The strain pattern's association with LVH persists independently of confounding factors, suggesting its clinical utility.