J Korean Acad Fam Med.  2005 Sep;26(9):551-560.

Electrocardiogram as a Diagnostic Method for Left Ventricular Hypertrophy

• Shin YJ
• Choi EJ
• Yu DS
• Lee DY
• Oh MK
• Cheong SS
• Park WS

Abstract

BACKGROUND
The purpose of this study was to examine the sensitivity and specificity of ECG as a tool for detecting echocardiographically defined LVH in a population-based sample and to examine the impact of a variety of factors that affect the sensitivity and specificity of ECG for detection of LVH.
METHODS
A total of 1,130 subjects who received a thorough medical checkup for cardiologic department voluntarily were selected. The subjects were examined using M-mode echocardiography and standard 12-lead ECG. The chi-square test was used to test for differences in sensitivity and specificity of ECG for echocardiographically defined LVH. Cochran-Mantel-Haenszel statistic was used to adjust for sex, age, and obesity and to test the association between cigarette smoking, amount of alcohol, exercise, hypertension, diabetes mellitus (DM) and sensitivity and specificity of ECG.
RESULTS
Echocardiographic LVH was detected in 434 (38.4%) and electrocardiographic features of LVH were present in 146 (12.9%). ECG for diagnosis of LVH showed sensitivity of 20.0%, specificity of 91.5%, and diagnostic accuracy of 64.1%. Sensitivity of ECG for LVH was higher in persons with obesity (P=.04) or hypertension (P=.04). Specificity of ECG for LVH was lower in persons with hypertension (P=.003)
CONCLUSION
ECG has a low sensitivity and a high specificity for echocardiographically defined LVH. Attention must be paid to carefully interpret ECG for diagnosis of LVH in persons with obesity or hypertension, because the rate of false positives and negatives can be increased.

Keyword

left ventricular hypertrophy; electrocardiogram; echocardiogram; sensitivity; specificity

MeSH Terms

Diabetes Mellitus
Diagnosis
Echocardiography
Electrocardiography*
Humans
Hypertension
Hypertrophy, Left Ventricular*
Obesity
Sensitivity and Specificity
Smoking