Tariq Waseem, Muhammad Arif Nadeem, Turab Ali, Abdul Hafeez Khan.
Left Ventricular Hypertrophy (LVH): Sensitivity of Different Electrocardiographic Criteria to diagnose LVH in patients having increased Left Ventricular Mass Index on Echocardiography.
Ann King Edward Med Uni Jan ;9(2):101-4.

Left ventricular hypertrophy (LVH) is an independent risk factor increasing cardiovascular mortality. Left ventricular mass (LVM) determined on echocardiography (ECHO) is most sensitive tool to diagnose LVH but ECG remains a useful initial investigation. However, its accuracy is often questioned. We conducted this study in July 1999 to Jan. 2000 to find out the reliability of various ECG criteria currently used to diagnose LVH in patients having increased LVM on echocardiography. The study was conducted in ECHO Room East Medical Ward (EMW), Mayo Hospital, Lahore. The average age and weight of patients were 52 years and 76kg respectively. The average height was 166cm. Thirty four percent patients were having ideal body mass index (<25Kg/m), while 66% patients had more than it. The average left ventricular mass was 358Gm. Eighty percent of patients had known cause for their LVH. Twenty percent patients had >= 5 and 80% =< 4 ECG criteria for LVH. Ninety percent patients had at least one chest lead criteria. Eighty six percent patients had one of Romhilt-Estes point score system (REPSS) ECG criteria for LVH with 66% having left atrial hypertrophy, 56% having strain pattern and 40% had left axis deviation. Thirty four percent patients met increased QRS voltage criteria. REPSS and/or QRS voltage in all leads are reliable criteria for LVH on ECG with the sensitivity of 86%. The more popular increased QRS voltage criteria have a sensitivity of 34% only. Echocardiography remains the gold standard to diagnose LVH.

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