Number 4 Suppl

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Posted in Volume 15 - Number 4 Suppl

HAKIM ALI ABRO, HABIB-UR-RAHMAN QADRI, ALAM IBRAHIM SIDDIQUI, NAHEED SHAIKH, SHABANA LAKHO, SHEERAZ BURIRO

ABSTRACT | Full Text PDF

OBJECT: To determine the sensitivity and specificity of different electrocardiographic criteria for left ventricular hypertrophy with reference to echocardiography.

DESIGN: Descriptive study.

SETTING:    Medical Unit III, Jinnah Post-graduate Medical Centre Karachi.

DURATION: June 1998- February 1999.

METHODS: 50 patients with proved echocardiographic left ventricular hypertrophy (LVH) and 25 normal persons without echocardiographic LVH were included in the study. All patients and healthy person were examined clinically and their ECGs were taken on the same day. Echo LVH was defined if Left Ventricular Mass Index exceeded 118 g/ m2 in males and 104 g/m2  in females. Data was preserved and now it is analyzed for Electrocardiographic LVH in view of (i) Gubner Ungerleider criterion (ii) Sokolow Lyon RaVL criterion  (iii) Sokolow Lyon Sv1  + Rv5/6  criterion (iv) Romhilt Estes Score system (v) cornell voltage criterion and (vi) cornell product index. Sensitivity and specificity was calculated by standard formula and P value derived by chi square test.

RESULTS: 50 patients, 21(42%) were male and 29 (58%) were females. 25 healthy persons without LVH,12 (48%)were males and 13 (52%) were females. Gubner Ungerleider criterion was 29% sensitive in males, 10% sensitive in females and 18% in all patients. Sokolow Lyon  RaVL criterion was 24% sensitive in males, 10% in females and 16% sensitive  in all patients; with 96% specificity.  Sokolow Lyon Precordial criterion was having sensitivity of 48% in males, 31% in females and 38% in all patients; while 100% specific. Romhilt Estes point score system was achieving sensitivity of 67% in male population, 31% in female population and 46% in all patients. It was 100% specific. Cornell voltage criterion was having sensitivity of 48% as over-all, 48% in males and also 48% in females. It was 96% specific. Cornell product index was the highest sensitive by achieving 57% in males, 62% in females and 60% in all patients.

CONCLUSION: Electrocardiography though less sensitive than echocardiography, can perform better in certain groups and with improved criteria. Cornell product criterion has the highest sensitivity.