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The relationship between electrocardiographic left ventricular hypertrophy criteria and echocardiographic mass in

Siri Sjöberg1, Frida Sundh2, Todd Schlegel3

  • 1Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Duke University, Durham, NC, USA.

Journal of Electrocardiology
|April 14, 2015
PubMed

Insights

Electrocardiogram (ECG) criteria for left ventricular hypertrophy (LVH) are unreliable for assessing left ventricular mass (LVM) in transcatheter aortic valve replacement (TAVR) patients. QRS duration showed a moderate correlation with LVM.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Valvular Heart Disease

Background:

  • Calcific aortic stenosis (AS) is a prevalent condition in the elderly, often leading to left ventricular hypertrophy (LVH) and heart failure symptoms.
  • Transcatheter aortic valve replacement (TAVR) is a treatment for severe AS.
  • Previous research indicates poor correlation between electrocardiogram (ECG) criteria for LVH and echocardiographic left ventricular mass (LVM), but this has not been studied in TAVR patients.

Purpose of the Study:

  • To assess the diagnostic and quantitative accuracy of ECG LVH criteria for evaluating LVM in patients undergoing TAVR.

Main Methods:

  • Twenty-four TAVR patients without pacemakers or bundle branch block underwent pre-procedural ECG and echocardiography.
  • ECGs were analyzed using Sokolow-Lyon, Romhilt-Estes, and Cornell Voltage criteria for LVH, alongside spatial maximal QRS-T angle and 3D QRS maximal vector.
  • Left ventricular mass (LVM) was quantified via echocardiography.

Main Results:

  • 15 patients (63%) exhibited LVH by echocardiography.
  • ECG criteria positivity rates were: Sokolow-Lyon (29%), Romhilt-Estes (21%), and Cornell Voltage (50%).
  • No significant correlation was found between LVM and conventional ECG LVH criteria or spatial parameters. QRS duration demonstrated a moderate correlation with LVM (r=0.56, p=0.005).

Conclusions:

  • Conventional ECG criteria for LVH are not recommended for LVM evaluation in TAVR patients.
  • QRS duration is the most useful ECG parameter, showing a moderate correlation with LVM in this cohort.
Abstract

Keywords:
Aortic stenosisEchocardiographyElectrocardiographyLeft ventricular hypertrophyTranscatheter aortic valve replacement

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