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Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
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Are Electrocardiographic Criteria Reliable for Left Ventricular Hypertrophy Detection in Indian Adults?

Bhuvaneswari Kothendaraman1, Tiroumourougane Serane V2, Kavitha Balasubramanian1

  • 1Department of Medicine, Indira Gandhi Medical College & Research Institute, Puducherry, IND.

Cureus
|July 14, 2023
PubMed

Insights

Electrocardiogram (ECG) criteria for detecting left ventricular hypertrophy (LVH) showed poor accuracy in high-risk Indian adults. The study found none of the tested ECG methods were sensitive enough for reliable LVH diagnosis, limiting their clinical use.

Area of Science:

  • Cardiology
  • Medical Diagnostics
  • Biomedical Engineering

Background:

  • Left ventricular hypertrophy (LVH) is crucial for cardiovascular risk stratification.
  • Electrocardiogram (ECG) is a widely used, non-invasive screening tool for LVH.
  • Accurate LVH detection aids in managing risks for coronary heart disease, cerebrovascular disease, and aortic aneurysms.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of seven common ECG criteria for LVH detection.
  • To compare ECG-based LVH diagnosis against echocardiography in high-risk Indian adults.
  • To assess the clinical relevance of ECG criteria in identifying cardiac remodeling.

Main Methods:

  • Adults over 18 with cardiac risk factors underwent ECG and transthoracic echocardiography.
  • Left ventricular mass index (LVMI) from echocardiography served as the gold standard for LVH.
  • Precision and accuracy of seven ECG criteria were calculated against echocardiographic findings.

Main Results:

  • Out of 220 participants, 96 had LVH confirmed by echocardiography.
  • Significant variability was observed in LVH detection rates across different ECG criteria.
  • No ECG criterion demonstrated good agreement with echocardiography for LVH detection.

Conclusions:

  • Current ECG criteria lack sufficient sensitivity for reliably ruling out left ventricular hypertrophy.
  • While some ECG criteria showed high sensitivity for cardiac remodeling, their low specificity limits clinical utility.
  • The diagnostic performance of standard ECG criteria for LVH in high-risk Indian adults is inadequate.
Abstract

Keywords:
12-lead ecgecg criteriaechocardiographyleft ventricular hypertrophysouth indian

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