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[Left arterial overload. Electro-echocardiographic correlations]

N R Koehler1, F J Velho, I C Collar

  • 1Hospital São Lucas, Porto Alegre, RS.

Arquivos Brasileiros De Cardiologia
|April 1, 1993
PubMed
Summary

Electrocardiography (ECG) shows limited accuracy in diagnosing left atrial enlargement (LAE). Atrial fibrillation and specific P wave changes in V1 demonstrated the highest correlation with echocardiographic findings for LAE.

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Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Electrocardiography

Background:

  • Left atrial enlargement (LAE) is a significant indicator of cardiovascular disease.
  • Accurate diagnosis of LAE is crucial for risk stratification and management.
  • M-mode echocardiography is the established gold standard for LAE assessment.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of various electrocardiographic (ECG) criteria for detecting left atrial enlargement (LAE).
  • To compare ECG-based LAE diagnosis with M-mode echocardiography findings.

Main Methods:

  • A study of 273 patients (age 17-87) with diverse cardiac conditions.
  • Evaluation of specific ECG criteria: P terminal force in V1, P wave duration and notching in D2, and presence of atrial fibrillation.

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  • M-mode echocardiography was used as the gold standard to measure left atrial dimension (>40 mm).

    • Main Results:

    • Atrial fibrillation showed the highest diagnostic accuracy (88%) for LAE.
    • Other ECG criteria, including Morris index (75%) and P terminal force in V1 (74%), demonstrated moderate accuracy.
    • P wave duration in D2 had the lowest accuracy (46%).

    Conclusions:

    • Conventional ECG criteria have limited sensitivity and specificity for diagnosing LAE.
    • Atrial fibrillation and specific P wave abnormalities in lead V1 show a stronger correlation with echocardiographically determined LAE.
    • Further research may refine ECG interpretation for improved LAE detection.