Electrocardiography and Echocardiography Correlation in Patients of Left Ventricular Hypertrophy
Dr. Sunil Kumar,
Professor, Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science (Deemed to be University), Wardha, Maharashtra, India.
Introduction: Electrocardiography (ECG) is the most common investigation for evaluation of Left Ventricular Hypertrophy (LVH), an important parameter of cardiovascular morbidity and mortality. This can also be evaluated by Echocardiography (Echo), which is superior to ECG but costlier, thus a major constraint in rural set ups.
Aim: To correlate the relationship of ECG and Echocardiography for the diagnosis of left ventricular hypertrophy and to find out sensitivity and specificity of various electrocardiographic criteria.
Materials and Methods: A total of 500 patients showing left ventricular hypertrophy by any of the mentioned ECG criteria, were enrolled in the study. Eight ECG criteria (Sokolow Lyon index, Romhilt Estes point score system, Talbot Criteria, Robertsâ€™s criteria, Cornell Criteria, McPhie criteria, Casale criteria and Criteria of Koitos & Spodick) and Echocardiogram were taken into account for the diagnosis. The statistical tests were performed using SPSS version 10.0. Diagnostic validity tests such as sensitivity, specificity Positive Predictive Value (PPV), Negative Predictive Value (NPV) and diagnostic accuracy were calculated.
Results: Out of 500 patients, 270 (54%) had LVH on Echo which was the gold standard investigation for the diagnosis of LVH in this study. Sokolow Lyon criteria showed sensitivity of 77.78%, specificity of 60.87%, PPV of 70%, NPV of 70% and accuracy of 70%. Comparison of Combined or either one of Sokolow Lyon and Romhilt Estes point score system on ECG with Echo for LVH showed sensitivity of 100%, specificity 60.87%, PPV 75%, NPV 100% and diagnostic accuracy of 82%.
Conclusion: Adding two, three or four criteria except Sokolow Lyon and Romhilt Estes point score system does not increase the diagnostic efficacy of the electrocardiography for left ventricular hypertrophy.