Related Experiment Video
Updated: Jun 22, 2025
Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery
Published on: February 20, 2017
The use of echocardiography compared to electrocardiogram when screening for left ventricular hypertrophy in
Marijn Marc Bult1, Thomas Flint van de Ree1, Anna Maria Wind2
1Department of Internal Medicine, Diakonessen Hospital Utrecht, Utrecht, Netherlands.
Insights
Electrocardiogram (ECG) has limited value for detecting left ventricular hypertrophy (LVH), a key indicator of hypertension-mediated organ damage. Echocardiography is recommended for accurate LVH assessment and optimizing hypertension treatment.
Area of Science:
- Cardiology
- Hypertension Research
- Diagnostic Imaging
Background:
- Left ventricular hypertrophy (LVH) is a critical marker for hypertension-mediated organ damage (HMOD).
- Accurate assessment of HMOD is vital for effective hypertension treatment optimization.
- Electrocardiogram (ECG) is commonly used to screen for LVH, despite concerns about its reliability.
Purpose of the Study:
- To evaluate the diagnostic accuracy of ECG for detecting LVH compared to echocardiography.
- To determine the sensitivity and specificity of ECG in identifying LVH in patients with suspected resistant or secondary hypertension.
Main Methods:
- A prospective study involving 329 patients with suspected resistant or secondary hypertension.
- Comparison of LVH diagnosis between ECG and echocardiography (reference standard).
- Calculation of ECG sensitivity, specificity, and area under the ROC curve.
Main Results:
- Echocardiography identified LVH in 70 participants (21.3%).
- ECG demonstrated a sensitivity of 47.9% and a specificity of 75.3% for LVH detection.
- The area under the ROC curve for ECG was 0.604, indicating limited diagnostic performance.
Conclusions:
- ECG has limited value in accurately diagnosing left ventricular hypertrophy.
- The utility of ECG for assessing HMOD in hypertension management is questionable.
- Echocardiography is recommended as a more reliable diagnostic tool for LVH.
Abstract:
Left ventricular hypertrophy (LVH) is often used as an indicator to assess hypertension-mediated organ damage (HMOD), alongside hypertensive retinopathy (HR) and nephropathy. Assessment of HMOD is crucial when making decisions about treatment optimization. Despite longstanding debate over its reliability to detect LVH, it is common practice to perform an electrocardiogram (ECG) instead of directly assessing left ventricular mass with echocardiography. In this study, the presence of LVH was evaluated using both ECG and echocardiography among consecutive patients suspected of therapy-resistant hypertension or secondary hypertension in the outpatient clinic of the Department of Internal Medicine at the Diakonessen Hospital, Utrecht, the Netherlands, between July 15, 2017, and July 31, 2020. The primary endpoints were the specificity and sensitivity of ECG as a diagnostic tool for LVH, with echocardiography serving as the reference method. Among the 329 participants, we identified 70 individuals (21.3%) with true LVH based on echocardiography. The ECG displayed a sensitivity of 47.9% and a specificity of 75.3%. Moreover, the area under the receiver operating characteristics curve was 0.604. In conclusion, ECG demonstrates limited value in identifying LVH. Considering the importance of accurately assessing HMOD for treatment optimization of hypertension, the role of ECG as a diagnostic tool for LVH is, therefore, questionable. Instead, we recommend employing standard echocardiography as a more reliable diagnostic.
More Related Videos
Related Concept Videos
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
01:29Electrocardiogram
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
01:28Electrocardiogram Fundamentals
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:26Exercise Stress Test
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes