Published online Mar 26, 2017. doi: 10.4330/wjc.v9.i3.248
Peer-review started: July 29, 2016
First decision: September 8, 2016
Revised: October 7, 2016
Accepted: December 27, 2016
Article in press: December 28, 2016
Published online: March 26, 2017
To investigate validity of electrocardiographic (ECG) criteria for left ventricular hypertrophy (LVH) in young adults.
Retrospectively, echocardiograms showing LVH and concomitant electrocardiograms were collected in patients 18 to 39 years old. A control group of patients without LVH was collected. Using echocardiogram as the gold standard, electrocardiograms were analyzed using common voltage criteria.
Study included 100 subjects (52% male, mean age = 28 ± 6.8 years, 96% Hispanic or African-American) with 50% LVH prevalence. Sensitivity and specificity for Sokolow-Lyon criteria were 24% (95%CI: 13.5%-38.4%) and 88% (95%CI: 74.9%-95%). For Cornell criteria, sensitivity was 32% (95%CI: 19.9%-46.8%) and specificity 98% (95%CI: 87.9%-99.8%). For R in aVL criteria, sensitivity was 12% (95%CI: 4.9%-25%) and specificity 100% (95%CI: 91.1%-100%).
In young adults common ECG voltage criteria have low sensitivities and high specificities similar to other age groups. Low sensitivities preclude these ECG criteria from serving as effective screening tests.
Core tip: The electrocardiographic (ECG) has been used for years to diagnose left ventricular hypertrophy (LVH). However, to the best of our knowledge, there were no prior studies validating most common ECG criteria for LVH in young adults. The authors believe that this is important group of population, as athletes screening for pre participation to professional sport falls into this category. ECG is one of the proposed screening tools and we think that it should be validated for diagnosis of LVH. This study showed that common ECG criteria for LVH can be used in young adults with similar sensitivity and specificity to other age groups.