Electrocardiography versus Echocardiography for assessment of left ventricular hypertrophy in ischemic heart disease patients with and without cardiovascular risk factors

Moustafa, Mansour Mohammed; Shredah, Abdel Aziz Rezk; Marghany, Kamal Ahmed; Zakaria, Ahmed Yahya Sayed

doi:10.21608/ejhm.2019.26382

Electrocardiography versus Echocardiography for assessment of left ventricular hypertrophy in ischemic heart disease patients with and without cardiovascular risk factors

Document Type : Original Article

Authors

Department of Cardiology, Faculty of Medicine, Al-Azhar University

10.21608/ejhm.2019.26382

Abstract

Background: it is well documented that left ventricular hypertrophy (LVH) detected by 12-lead electrocardiography or echocardiography is a major risk factor for cardiovascular morbidity and mortality in cohorts ranging from the general population to those with established cardiovascular disease, including coronary artery disease (CAD).
Objectives: aims of this study were to detect prevalence of LVH in CAD patients by standard echocardiography by measuring LVM indexed to body surface area and to test the sensitivity and specificity of new ECG criteria, Peugero-Lo Prosti criteria, for detection of left ventricular hypertrophy and comparing it with other ECG criteria to diagnose LVH.
Patients and Methods: This observational cross sectional study was conducted at El-Hussein University Hospital and Minia Health Insurance Hospital during the period from July 2016 to June 2017, the study involved 230 patients of either sex, and referred for Echocardiography department to perform 2D transthoracic echocardiography.
Results: In our study, we founded that firstly, the echo-LVH is prevalent in CAD patient (41.5%) regardless the presence of other cardiovascular risk factors. Moreover, our results showed that, the prevalence of echo-LVH is significantly higher in patients with CAD and hypertension, than in patients with CAD only (54% Vs. 32%). Secondly, the Peguero-Lo Prosti criteria has a higher sensitivity (61.4%) for detecting LVH among the patients with CAD than Sokolow-Lyon criteria (26.5%), Cornell voltage criteria (32.5%) and Romhilt Estes point score (41%) considering LVMI by echocardiography as reference standard.
Conclusion: the prevalence of echocardiographic LVH in CAD patient is high regardless the presence of other cardiovascular risk factors. Overall the present study shows that, Peguero-Lo Presti criteria has higher sensitivity and specificity in the ECG diagnosis of LVH compared to Sokolow-Lyon criteria, Cornell voltage criteria and Romhilt-Estes point score system considering LV mass index by 2D Echocardiography as reference standard.

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